Routine inspection·August 9, 2021

At 2:05PM, Licensing Program Analyst (LPA) Steve Chang arrived at facility, and rang the bell. Staff Monette Encina (S1) opened the door for LPA, and took LPA's body temperature. S1 conducted the COVID-19 infection questionnaire. S1 checked in LPA in the visitor log. LPA observed the COVID-19 posters in the main entrance and facility. S1 and ADM toured LPA inside out of the facility. There are 4 bedrooms for residents and two bedrooms for staff. Two bedrooms are shared rooms for residents, and two bedroom are single rooms for residents. The beds in the shared rooms have the separators between two beds. There are two and half bathrooms in the facility. LPA observed all the trash bins in the bathrooms and kitchen have covers. The room temperature is 72 degree F. LPA inspected the food supplies. LPA observed two day perishable and seven day non perishable foods are adequate. ADM provided the roster of residents. LPA observed staff S2 and residents (R1 - R6) in the facility. LPA reviewed and discussed LIC808 with ADM. ADM stated all the residents and staff are fully vaccinated. No citation was issued during today's inspection. Exit interview conducted with ADM. A copy of this report was provided to ADM for signature. A copy of this report was emailed to ADM.