Routine inspection·December 2, 2021

Licensing Program Analyst (LPA) Arlene Garcia conducted an unannounced annual / Infection Control visit on this date. LPA was greeted by Norma Casaverde , Caregiver (S1) met with Lovelynn Bay,, Administrator (AD). LPA and S1, inspected physical plant including but not limited to the main kitchen, residents bedrooms and bathrooms, and dining/ living room areas. Upon entry, sign in sheets were observed to document date and visitors name. Sign in sheets did not include symptom screening for reporting requirements to public health officer and contact tracing. All persons in facility fully vaccinated LPA observed resident practicing social distancing. LPA observed 30 days PPE supply. LPA observed sufficient 7 days non-perishable and 2 days perishable food supplies.. Hot water temperature measured 105.4 degrees in residents bathroom with the S1 which is in required range of 105 to 120 degrees. LPA observed sharps and toxins not locked. Last Fire Drill conduced dated 2/3/2020 Fire extinguisher maintained 7/01/2021. Fire alarm and carbon monoxide functional. LPA and S1 observed centrally stored medications. LPA reviewed 3 staff and 4 resident files. Resident emergency contact complete. LPA observed all staff files complete. Administrator Certificate valid until 8/20/2022. Per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited today in violation of California Code of Regulations. Exit interview held with AD and a copy of report given via email.