Routine inspection·February 21, 2023

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced on-site one-year Infection Control Inspection visit to the above-named facility. LPA arrived at 1:53 pm and was greeted by Administrator Miriam Santiago. LPA explained the purpose of the visit. Entrance interview conducted. The facility is a one-story Residential Care Facility for the Elderly (RCFE) with a hospice waiver for 18. Currently, there are 18 residents with a dementia diagnosis and 3 residents on hospice. A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster, bill of rights and Resident’s Rights. LPA inspected the facility for personal accommodations, food service, and fire safety. The facility has 3 fire extinguishers serviced on 1/5/2023; 5 fire pull alarms, and a sprinkler system. The physical environment was checked for cleanliness and condition. Walls, windows, ceilings, doors, floors and floor coverings were checked. The facility maintains a comfortable temperature. The kitchen is equipped with industrial kitchen equipment and is kept neat and clean. There is a sufficient amount of perishables for two-days and non-perishables for seven days. Medications and First Aid kits are kept in the locked Nurse’s station. Residents’ records and personnel records are kept in a locked closet in the hallway. Only the Administrator can access the records. Residents participate independently in live entertainment and music, worship support, exercise activities, card games, Bingo, and scenic drives. If any suspected or confirmed cases of COVID-19 are found in the facility a staff will be assigned to only work with those quarantined/isolated individuals and will not work with other COVID-19 negative individuals until cleared by Health Department. Staff will use full PPE with N95 masks and face shields when dealing with any pending or confirmed cases of COVID-19. Precautionary Droplet signs will be posted on any room with quarantine or isolated individuals. Please continue to 809-C, Pg 2. PPE supplies will be located immediately outside those rooms when required. Facility has a 30-day supply of PPE on hand. Facility has plans for delivering medications and meals to any quarantined/isolation resident room. The facility has proper cleaning and disinfectant sprays. Facility Administrator has a plan in place for when and whom to notify in an outbreak or other emergencies. Administrator will keep a line list of all vaccinated and tested staff/residents in care with dates/results. Facility has conducted training on infection prevention, symptoms, transmission and PPE use. Facility has non-punitive sick leave polices for staff. Staff who have a respiratory illness are requested to stay home and not report to work. Activities have been modified to individuals or small groups with social distancing. Residents' medication is delivered in 30-day supplies to the facility. The facility ensures proper cleaning is done on frequently touched surfaces and between any individuals sharing of space or items. Sinks were well stocked with soap, paper towels and hand washing signs. Staff and resident records are kept in the locked Nurse's station. Facility observes guidance changes and the most up-to-date guidance from CCL-PINS, CDC, CDPH, and local health departments should be followed to remain in compliance. The most stringent orders should be followed by any of these agencies. At approximately 2:14 pm, LPA observed Staff 1 with no face covering at the time of inspection. LPA requested S1 to put on a face covering and wear it in the facility at all times. S1 agreed to do so. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Civil penalties assessed. Exit interview conducted. A copy of this report, Appeal Rights, and Civil Penalty issued.