Routine inspection·June 10, 2021

Licensing Program Analyst (LPA) Kennedy made an unannounced visit to the facility to conduct an annual required licensing inspection. LPA identified herself, and met with Stephany Haro, Lead Caregiver and discussed the purpose of today’s visit. A tour of the facility was conducted inside and out. LPA, accompanied by Ms. Haro conducted a general overall inspection, with specific focus on infection control. LPA was joined by Cynthia Grape, Administrator. During today's inspection LPA observations include the following: Symptom screening procedures for staff, residents and visitors; posted signs including visitor policy, promoting hand washing, cough and sneeze etiquette and other infection control procedures; Hand hygiene practices; testing plan and procedures; plans for containing infections, PPE supplies procedures and training; and disinfection procedures. Based on today’s inspection, no deficiencies were observed at this time in the areas evaluated. This report was discussed with Cynthia Grape. A copy of this report was emailed to Ms. Grape at the conclusion of the visit. An electronic response confirms the receipt of these documents. Licensee Rights (01/2016) were left with Ms. Grape at the facility. Please submit a current Designation of Administrative Responsibility LIC 308, Personnel Report LIC 500 and Emergency Disaster Plan LIC 610-D to the licensing office within 10 business days . Forms available at www.ccld.ca.gov