Routine inspection·July 16, 2021

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Corine Bernard. During visit, LPA Marrufo toured the facility. LPA Marrufo observed there to be a visitor screening area in the facility entrance. LPA Marrufo toured four resident living units and found the residents had adequate supplies of soap and paper towels in the bathrooms. LPA Marrufo toured the facility medicine rooms on the top and second floors and the facility storage room in the basement floor and observed there to be a PPE supply of at least 30 days. LPA Marrufo observed the facility staff break rooms and dinning rooms. No deficiencies were cited as per California Code of Regulations Title 22. LPA Marrufo requests that the following documents be updated and copies sent to CCLD: LIC500 Personnel Report LIC308 Designation of Administrative Responsibility LIC610 Emergency Disaster Plan This report was reviewed with Administrator Corine Bernard and a copy of the report has been provided.