Routine inspection·March 17, 2022

On March 17, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. Upon arrival, LPA observed COVID-19 signage on the front door. LPA met with Caregiver, Benilda Briones and Assistant Administrator, Matthew Montilla, joined shortly thereafter. LPA explained the purpose of the visit and was screened at entry point. Assistant Administrator was able to provide screening log documentation for residents, visitors, and staff. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are present: entry procedures, daily monitoring for residents and staff, and 30-day PPE supply. LPA observed the bathrooms at the facility. LPA advised Assistant Administrator to make sure all bathrooms have a covered trash bin and that hand/bath towels should not be present in the bathrooms or the kitchen. LPA observed a total of 11 bedrooms at the facility, 3 of which are shared rooms with beds 6ft apart. During the visit LPA observed 6 residents eating breakfast in the dining room and 2 residents in the living room maintaining social distance. LPA Charitra observed COVID signage throughout the facility but advised Assistant Administrator to post more reminder signage (masking, social distance, and cough etiquette). Medications, toxins and sharps are stored appropriately and inaccessible to residents, and a comfortable temperature is maintained, lighting is sufficient for comfort. First aid kit was observed to be completed. LPA observed the facility elevator to have signage posted both inside and outside. LPA requests the following forms to be sent to CCLD by 3/24/22: LIC308 Designation of Administrative Responsibility LIC500 Personnel Report LIC610E Emergency Disaster Plan No citations issued during the visit. LPA reviewed report with Matthew Montilla and a copy is provided.