Routine inspection·July 25, 2022

LPA Audrey Jeung toured facility and grounds, consisting of 6 private client bedrooms, each with a half bathroom, and a staff bedroom, plus 1 common full bathroom, kitchen/dining area, living room.. The upper level has a separate entrance and is not used as part of the RCFE. It is a rental unit and currently occupied by someone that is fingerprint cleared. There is a 1 car garage that is used for storage, and a laundry room. No accessible bodies of water are present. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring, containment strategies, environmental preparation and cleaning. PPE supply is adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 6 residents present, and 2 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, in addition to health screenings, TB test results, and valid first-aid training. Ante Buljan and Noralee Reyes are certified RCFE administrators (x 1/23 and 9/23) that oversee facility operations. The following updated forms/information are requested to be submitted to CCLD BY 8/15/22: • LIC 309 Administrative Organization • LIC 308 Designation of Administrative Responsiblilty • LIC 500 Personnel REport • Current liability insurance Updated Emergency Disaster Plan (LIC 610E) is provided to LPA today. No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See 4 Advisory Notes given to Ms. Reyes for additional information.