Follow-up·April 15, 2021

Licensing Program Analyst (LPA) Kennedy conducted a Change in Ambulatory Status Visit via video calling app due to COVID 19 restrictions to observe the physical plant for compliance per Title 22, Division 6 of the CA Code of Regulations and Health & Safety codes. The facility has requested a change from 4 non-ambulatory and 2 ambulatory to 6 all non-ambulatory. One resident may be bedridden. A fire clearance was granted by the local fire authority and received by CCL on 4-12-21, The LPA met with licensee and administrator Jonathan DeVera. Mr. De Vera provided the LPA with a virtual tour of the facility. LPA observed resident accommodations including furnishings, linens and personal hygiene items; resident bathroom was equipped with grab bars and bath mats; food service including dishes, utensils, food storage and a seven day supply of nonperishables and a two day supply of fresh perishables are present; medication storage is located in a locked closet; first aid kit and current first aid manual are located in the main living area of the home; activities, supplies and sufficient space to conduct are present; a fire extinguisher is present and is affixed with a current tag; smoke and carbon monoxide detectors are present and operable; facility posting requirements are present in a common area and the facility administrators certification is current; no pool or other body of water is on the property; LPA observed COVID screening station and COVID postings. The LPA is recommending the change in ambulatory status. An exit interview was conducted with Mr. De Vera via video-call. A copy of this report along with Licensee Rights (LIC9058 01/2016) was provided via email. An electronic response confirms the documents were received.