Routine inspection·August 24, 2022

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Jocelyn Real. Upon arrival, staff Garry Geronimo (S1) took LPA body temperature,, and checked LPA in the visitor log book. LPA toured the facility inside out with ADM. COVID posters were observed at main entrance and in the facility. Screening station with masks, hand sanitizer, thermometer and visitor log book was observed at the main entrance. Family room, kitchen, dinning room and two restrooms were inspected. All trash cans were observed with covers. Paper towels were observed with holders. Poster of washing hands for 20 seconds were observed by the sinks in kitchen and restrooms. Cloth towels were observed in kitchen. 3 shared resident bedrooms and laundry room were inspected. Beds in shared rooms were observed 6 feet apart. One staff live-in room was observed in facility. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. PPE supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 78 degree F, and hot water temperature was at 105 degree F in facility. 6 residents and 3 staff were observed in facility. All the 3 staff were associated with CCL database. Fire extinguisher was serviced on 06/17/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. ADM stated all the residents and staff are fully vaccinated and done with booster. ADM already submitted the Infection Control Plan to LPA. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.