Routine inspection·February 13, 2023

Licensing Program Analyst (LPA) Steve Chang conducted an annual inspection visit, and met with administrator (ADM) Jocelyn Real. Upon arrival, ADM took LPA body temperature, and checked LPA into the guest book. Screening station with thermometer, masks, hand sanitizer was observed at the main entrance. COVID posters were observed at the main entrance and in facility. 2 staff and 6 residents were observed in facility. LPA toured the facility inside and out with ADM. LPA inspected living room, kitchen, dinning area, laundry room and garage. Medication closet, knives closet, and cleaning product closet were observed locked. There are 3 shared resident rooms at first floor for residents, and 2 restrooms for residents at first floor. There are 3 staff live-in rooms, 1 office room, and 1 restroom at the second floor in facility. Beds in shared bedrooms were observed 6 feet apart. Trash cans were observed with covers. Posters of washing hands for 20 seconds were observed by the sinks in kitchen and restrooms. Paper towels were observed with holders. Room temperature was observed at 70 degree F, and hot water temperature was observed at 110 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. PPE supplies were observed sufficient. The facility is equipped with smoke and carbon monoxide detectors. The facility equipped with fire alarm. ADM tested the smoke and carbon monoxide detectors, and they were working fine. The fire extinguishers were observed on service on 1/16/2023. LPA inspected the backyard, there was no obstruction to block the walkway. ADM stated all staff are fully vaccinated and done with booster shots. ADM already submitted the Infection Control. Plan to LPA. No citation noted during inspection. Exit interview was conducted with ADM. This report was provided to ADM for signature.