Routine inspection·October 15, 2021

Licensing Program Analyst (LPA) Carmen Lopez made an unannounced visit to the facility to conduct an annual required licensing inspection. LPA identified herself and was granted entry by Monica Flores, Business Office Manager. LPA met with Bryan Kane, Maintenance Director and discussed the purpose of today’s visit. A tour of the facility was conducted inside and out. LPA, accompanied by Maintenance Director Kane conducted a general overall inspection, with specific focus on infection control protocols. During today's inspection LPA observations include the following: Symptom screening procedures for staff, residents and visitors; posted signs regarding visitor policy; hand washing, cough and sneeze etiquette and other infection control procedures; 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. An exit interview was conducted with Bryan Kane, Maintenance Director. A copy of this report, along with the Licensee Rights (01/2016) was emailed to Diane Domingo, Executive Director (ED), at the conclusion of the visit. LPA requested ED to send LPA an electronic message reply confirming receipt of these documents. LPA requested ED to submit a current Designation of Administrative Responsibility LIC 308, Personnel Report LIC 500 and Emergency Disaster Plan LIC 610-E to the licensing office within 10 business days. Forms available at www.ccld.ca.gov .