Routine inspection·July 30, 2021

LPA Audrey Jeung toured facility and grounds, consisting of 6 private client bedrooms, each with a half bathroom, and a staff bedroom on the main level, plus 1 common full bathroom. There is an attic that is accessed from staff room by pull down ladder, with 3 rooms and a small room that appears to be an unfinished bathroom. There is a 2 car garage that is used for storage, and laundry. 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. Olivia De Guzman is a certified RCFE administrator (x 6/22) that oversees facility operations. The following updated forms/information are requested to be submitted to CCLD BY 8/6/21: • LIC 999 Facility Sketch, including attic • Current liability insurance Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed and cited on a following page.