Routine inspection·September 16, 2021

On 09/16/2021, Licensing Program Analyst (LPA) Jaime Vado toured facility's building and grounds. LPA met with caregiver Emma Advincula and explained purpose of today's inspection. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring, containment strategies, environmental preparation and cleaning. PPE supply is observed as in place. Medications, toxins and sharps are stored appropriately and inaccessible to clients. Facility ambient temperature is comfortable, and lighting is sufficient for residents and staff safety. Toilet and bathing facilities are equipped with grab bars and non-skid flooring material. Liquid soap is available. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan dated 03/23/2020 is observed. There are 4 residents present and 2 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed. LPA is unable to review staff files due to the administrator locking the storage area. LPAs discussed entry question procedures and masking requirements as reminders. Staff were not wearing masks due to cleaning but masks are present for their use. Signs are present regarding masking and distancing but LPAs discussed the need to add more reminder signs for residents regarding cough etiquette, resident masking, and social distancing. LPA Vado will send licensee additional signs to add to facility. The following updated forms are requested to be submitted to CCLD by 09/24/2021 : • Administrator Certificate • LIC 308 Designation of Administrative Responsibility • LIC 309 Administrative Organization • LIC 500 Personnel Report • LIC 610E Emergency Disaster Plan • Updated lease agreement or control of property information Report reviewed with caregiver Emma.