Routine inspection·April 13, 2022

On this day at 1430 hours, Licensing Program Analysts (LPA) Jaime Vado conducted an unannounced infection control annual required inspection. LPA met with licensee Yvonne Kwok and explained purpose of today's inspection. LPA toured facility's building and grounds. Upon entry LPA was not screened for COVID with temperature taken and COVID related questions asked. Licensee did disinfect LPA shoe bottoms but did not screen for temperature or ask LPA any COVID screening questions. LPA did not observe any social distancing signs, cough etiquette signs, face covering signs, or COVID symptoms signs inside the facility. LPA is requesting the posting of these signs to go back up in the facility and at the front door. There are no accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring and staff monitoring, containment strategies, environmental preparation and cleaning are in place. PPE supply is observed as in place. LPA is recommending additional N95s to be in place in case of COVID outbreak. LPA informed administrator that additional PPE is available from the regional office upon request. Medications and toxins are locked and secured. 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 in resident bathrooms and paper towels for resident use. Hand washing signs are present in downstairs bathroom but upstairs resident bathroom does not have the hand washing sign. LPA requested a sign to be put in the upstairs bathroom. First-aid kit is inspected as complete. A Disaster and Mass Casualty Plan observed. There are 4 residents and 2 staff present. All staff wearing masks. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed as current. Administrator certificate expires 6/9/2022. All residents and staff are fully vaccinated and with booster. Mitigation plan has been received by CCLD and according to licensee it is current. Facility does not handle cash resources. The following updated forms are requested to be submitted to CCLD by 04/20/2022 : • LIC 308 Designation of Administrative Responsibility • LIC 500 Personnel Report • LIC 610E Emergency Disaster Plan • LIC 9020 Resident Roster • Updated copy of administrator certificate No deficiencies cited. Report is reviewed with Yvonne Kwok.