Routine inspection·February 21, 2023

On February 21, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. LPA met with Caregiver, Genalyn David and Administrator, Hui Leslie joined shortly thereafter. LPA explained the purpose of the visit. Upon arrival, LPA observed the COVID signage posted at the front entrance. LPA was screened at entry point and Caregiver was able to provide screening log documentation for visitors, residents and staff. LPA toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a double story home. LPA toured the first floor and observed 7 resident bedrooms; two of which are shared rooms with beds 6ft apart. LPA observed 3 full bathrooms and 2 half bathrooms. Bathrooms were equipped with liquid soap, paper towels and a trash can with a fitted lid. LPA advised caregiver to remove bar soaps from communal bathrooms. LPA observed extra linen present and first aid kit to be completed. LPA observed medication cabinet to be unlocked and accessible to residents. Caregiver locked the medication cabinet in LPA's presence. LPA observed living room and dining room to be clean and free from any tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. Overall the facility is odor-free and in good repair. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable, however LPA observed facility fridge to have expired milk. Sharps drawer was observed to be locked, however LPA observed a knife on the kitchen counter-top and no staff present. Expired milk was thrown away during the visit and caregiver put the knife in the locked cabinet. LPA toured the garage and observed chemicals and toxins cabinet to be unlocked. Cabinet was immediately locked by caregiver. In addition, LPA observed washer and dryer to be in good working condition and observed extra food supply present. 30-day PPE supply was present. (CONT. TO 809C) During the visit, LPA observed Staff 1 (S1) to not be fingerprint cleared and/or associated to the facility. According to the administrator, S1 will be going to get fingerprinted today. LPA toured second floor and observed 2 caregiver rooms and a full bathroom to be clean. 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. LPA requests the following forms to be submitted to CCLD by 2/28/23: -LIC308 Designation of Administrator Organization -LIC500 Personnel Report -LIC610D Emergency Disaster Plan -Administrator Certificate Report is reviewed with Administrator and a copy is provided with appeals rights.