Routine inspection·November 2, 2021

On November 2, 2021, Licensing Program Analyst (LPA) Komal Charitra, conducted an unannounced annual inspection. Upon arrival, LPA observed COVID-19 signage posted by the entrance. LPA was greeted by the Administrator, Renalin Salvadico and Iress Caguiat, Necia Conde, and Leandra Salvador joined shortly thereafter. LPA Charitra explained the purpose of the visit. LPA was not screened at the front entrance and the Administrator was not able to provide the daily visitor screening log documentation. LPA toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are not reviewed: entry procedures, resident and staff daily monitoring records, visitor screening log, and COVID-19 signage throughout facility. LPA discussed the need to add more reminder signs for residents and visitors regarding face covering and social distancing. LPA Charitra will send administrator additional signs to add to facility. There were two bathrooms observed during the tour; both equipped with liquid hand soap and paper-towels. LPA advised Administrator to cover the trash bins with lids. LPA observed 2 shared rooms with the beds either 6 feet apart or 3 feet apart from head-to-toe and 2 private rooms. Staff room observed to have 2 beds 3 feet apart head-to-toe. Extra linen was observed to be present. PPE supply and the environmental cleaning supply are adequate. 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. 2-day perishable and 7-day nonperishable food supply was present. The following forms are requested to be submitted to LPA by 11/9/2021: -LIC500 Personnel Report -LIC610E Emergency Disaster Plan -LIC309 Administrative Organization -Administrator Certificate Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the Administrator; a copy is provided.