Routine inspection·July 13, 2022

Licensing Program Analyst (LPA), Chinwe Nwogene made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA was greeted and granted entry by House Manager, Mary Jane Laygo who was informed of the purpose of the visit. At the time of visit there was 1 staff and 12 residents present. The facility currently has zero positive or suspected Covid-19 cases. During today's visit, LPA Nwogene toured the facility inside and out with the Mary Jane and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings posted throughout the facility. The facility has an adequate amount of hand hygiene supplies (soap, hand sanitizer and paper towel) in all restrooms. LPA did not observe any pools or bodies of water within the premises. LPA was informed that no weapons or ammunition is maintained at the home. Mary was informed of the annual fees due, Mary stated that annual fees will be paid tomorrow 7/14/2022. The facility has a plan in place to monitor residents regularly for any changes in condition, which includes daily temperature checks. The Facility will contact the resident's physician should there be any event of COVID-19 related illnesses. The facility has a designated infection control lead. The facility also cleans and disinfects the highly touched surfaces during each shift, and as needed. LPA observed PPE supplies. During the tour, LPA Nwogene also observed Kitchen knife laying on the kitchen counter. Mary Jane admitted facility has 3 dementia residents. Citation will be issued. Based on the observations made during today’s visit, the one (#1) deficiency was cited per Title 22, Division 6 of the California Code of Regulations. See LIC 809D. An exit interview was conducted, and a copy of this report was reviewed and provided along with appeal rights to Mary Jane Laygo