Routine inspection·June 24, 2021

On 6/24/2021, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual required inspection. LPA met with Caregiver, Michelle Perez. At 10:20am, LPA arrived at facility and was greeted by staff. LPA observed COVID-19 signs posted on the front entry point and staff took LPA's temperature but the facility ran out of the symptom review questionnaire so it was done on a piece of blank paper. At 10:30 am, LPA reviewed the COVID-19 logs and it indicated that the resident/staff daily monitoring log was last completed in December 2020; the last documented visitor screening questionnaire was completed on 3/24/2021 and the staff stated that they were never tested for COVID-19 except for the Administrator. At 11:00 am, LPA toured the facility beginning in the dining room and observed 2 sofas that are spaced out to promote social distancing. COVID-19 Infection Control signs are posted in the living/dining room but not in the hallway. LPA recommended to post COVID-19 signs in the hallway as well. There were residents watching TV without face covering. The caregiver stated that everyone has been vaccinated and it is a challenge to ask the residents to wear face covering but they will continue to encourage them to do so. Hand washing stations were equipped with paper supplies and soaps. The facility has two patios that are designated visitation areas. Both patios do not have any COVID-19 signs posted and LPA recommended to post signs in the patios. Patio 2 has three chairs that are not 6" apart and LPA recommended to remove one of them or put an "X" in the middle chair to ensure social distancing is maintained. Trash bins were observed equipped with foot operated lids. The bed rooms were observed to be furnished per Title 22 regulations. Beds were spaced at least 6 feet apart or 3 feet apart with head-to-toe orientation. Food supply was checked and observed to be sufficient. Medication cabinet was observed to be sufficient. Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 is observed and cited on a following page. This report was reviewed, discussed with caregiver, Michelle Perez and over the phone with the Administrator, Marlon Sicat. A copy is provided.