Routine inspection·October 21, 2021

On October 21, 2021, Licensing Program Analyst (LPA) Komal Charitra and Licensing Program Manager (LPM) Julio Montes, conducted an unannounced annual inspection. LPA and LPM observed COVID-19 signs posted by the entrance. LPA and LPM were greeted by Albert Liu (S1). LPA and LPM explained the purpose of the visit. LPA and LPM's temperature was checked at the front entrance, however, S1 did not ask screening questions. LPA toured facility grounds. No accessible bodies of water. The house consists of a central area with the dining area and living room area. There is access to the kitchen and the garage. To the left of the front door are 3 bedrooms and 2 bathrooms, and to the right from the entrance there is another bedroom. The floor plan appears to differ to the original plan of 2017. It is noted that a new facility floor plan was received by CCLD on September 3, 2019, showing that the staff bedroom had been converted to a residents' room, and a new structure built in front of the kitchen and converted to caregiver's room. The most recent fire clearance is dated May of 2017. A new fire clearance will be needed. Kitchen area is covered with plastic and has a locking device on the door. The bedrooms were observed and the beds in the semi-private rooms are 6 feet apart. Bathrooms were equipped with liquid hand soap. LPA advised S1 to get rid of bar soaps, have paper-towels instead of hand towels, and to cover trash cans with lids. Medications are locked and inaccessible to residents, however the keys are accessible to anyone. A comfortable temperature is maintained, lighting is sufficient for comfort. Infection control practices are not reviewed: entry procedures, COVID-19 signage, and 30-Day supply of PPE. According to S1, all residents are vaccinated and one is on Hospice. Two residents are in the hospital. LPA requests for the following documents be submitted by 10/28/2021: -LIC500 -A copy of 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 with S1 and a copy will be provided.