Routine inspection·August 18, 2021

On 08/87/21 at 10:15 AM LPA Bruce Jacobs arrived at this facility unannounced to conduct an annual inspection visit. LPA was met by care staff who informed Sonia Gapasin of the LPA's visit and Ms. Gapasin arrived during the visit. LPA explained the purpose of the visit and staff accompanied LPA on the facility inspection. LPA Jacobs inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry area, living area and other common areas, as well as outside of the facility to ensure compliance with Title 22 regulations. Facility is a 6 bed facility with a current census of 6. There are 3 client bedrooms and 2 client bathrooms. There is entry door is leading to the living room, kitchen with a hallway to the bedrooms and bathrooms. The hallway has COVID precautions in place including social distancing and other signage noted. Medications noted to be locked to residents in care. . LPA also conducted the infection control domain tool. The facility submitted a LIC 808 mitigation plan , which was approved. The facility has central entry point and has implemented screening and sign in procedures at the front door area. The facility conducts routine symptom screening for employees, residents, and visitors. LPA observed the facility to have hand washing stations, COVID - 19 informational signage, and social distancing signs posted throughout the facility, on the front door, and outside. The facility has a designated infection control lead individual. The facility is able to designate and dedicated a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. LPA observed the facility to have adequate food supply of 7 days non-perishables and 2-days perishables in place. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguishers were checked April 2021 and are in compliance. Facility has an emergency food and water supply in a separate storage area in kitchen. All staff on-site have current fingerprint clearances. Administrator Certificate # 6016991740 expires 7/24/23. LPA requested the following documents to be updated: LIC 500 and LIC 309 as needed. Per California Code of Regulations, Title 22 no deficiencies were observed during this visit. Exit interview was held and a report was given to Sonia Gapasin.