Routine inspection·August 31, 2021

On 8/31/21 at 11:24am, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Well Tabaco and explained the purpose of the visit. LPA Bilger inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. Facility is a 15 bed residential care facility for the elderly with a current census of 11. Facility has a main entry way and lobby . Facility also has a separate kitchen and dining room. All rooms are located down a hallway. There is an outside area for residents who smoke 20 feet from the building. Yard area has walking space for residents and activities. There is also a locked area for the water pump outside of facility. 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, COVID - 19 informational, and social distancing signs posted throughout the facility, on the front door, and back yard. The facility has a designated infection control lead. The facility is able to designate and dedicate a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. Water temperature reads 106.8*F in the bathroom and room temperature reads 75*F. LPA observed the facility to have adequate food supply. 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 extinguisher was checked 11/4/20. Facility has an emergency food and water kit. A review of 5 resident records was conducted. Per California Code of Regulations, Title 22, deficiencies were observed during this visit and noted on LIC 9099D. Exit interview was held and a report along with appeal rights was given to Administrator Well Tabaco