Routine inspection·September 23, 2022

On September 23, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. Upon arrival LPA observed the COVID signage posted at the front entrance. LPA met with Caregiver, Rolito Cawaling and Administrator Caridad Alexander joined shortly thereafter. LPA explained the purpose of the visit. LPA was asked to sign in and fill out screening log documentation. LPA observed the screening log documentation and the visitor sign in at the front entrance. LPA toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story home with 5 resident bedrooms, 2 full bathrooms, and an office room. LPA observed the office room. LPA toured the facility with Caregiver and observed both bathrooms to be clean and odor-free. Both bathrooms were equipped with liquid soap, paper-towels, hand-washing signs, non-skid mats, and a trash can with a fitted lid. LPA observed all 5 residents rooms of which 4 were observed to be private rooms and 1 was observed to be shared with beds 6ft apart. LPA observed Bedroom #2 door alarms, to not be working. Based on file reviewed, Resident #1 (R1) in bedroom #2, does not have dementia. Extra linen and supplies were observed to be present. LPA toured the dining room and living room to be clear from any tripping hazards. During the visit, LPA Charitra observed 4 residents in the living room watching television and maintaining social distancing. A comfortable temperature of 71 degrees F is maintained and lighting is sufficient for comfort. LPA observed the first aid kit to be completed and and medications to be locked and stored appropriately and inaccessible to residents. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable.Sharps, toxins, and chemicals were locked and stored away and inaccessible to residents. LPA toured the garage and observed chemicals and toxins to be locked. In addition, LPA observed washer and dryer to be in good repair and observed extra food supply present. Infection control practices are not observed: daily monitoring log for residents and visitors, 30-day PPE supply, and face coverings for staff. Cont. to 809C LPA requests the following forms to be submitted to CCLD by 9/30/2022: LIC308 Designation of Administrative Responsibility LIC500 Personnel Report LIC610E Emergency Disaster Plan Administrator Certificate Deficiency cited today under California Code of Regulations, Title 22, Division 6, Chapter 8 follows on LIC809D. If cited deficiency is not corrected by the due date, a civil penalty may be assessed. This report was reviewed and discussed with Administrator, Cari Alexander, and a copy is provided. Appeals Rights were given.