Routine inspection·August 9, 2021

Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. Infection Control inspection for this facility and met with Administrator, Jayson Sy (JS).The facility currently provides care for four (4) residents some of which with a diagnosis of dementia. LPA arrived at the facility and had temperature checked and logged. LPA continued with a tour of the facility with Administrator and facility staff; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher weas found to be last charged on 3/10/2021 at the time of the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in designated storage closets in the garage. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Hot water measured at 109.5 degrees F which is within Title 22 regulations of 105 to 120 degrees F in faucets used by residents. During the tour LPA observed two prescription medications in resident bathroom accessible to residents with dementia. Administrator and care staff immediately removed all medications from resident bathroom and placed in a secured medication cabinet (photos taken). In addition, LPA also observed an inoperable auditory alarm in R1's bedroom sliding door exit. Administrator immediately replaced the auditory alarm battery and LPA confirmed the alarm functions properly. Infection Control: Facility has submitted a mitigation program plan which has been approved. All staff and residents have been vaccinated with no reported or observed symptoms. Staff conduct surveillance testing weekly with 25% of staff every seven days. Posters have been placed at the front door, and facility has a station at main entrance with a sign in, hand sanitizer and other items designated for visitors and staff. Staff are screened for temperature and symptoms on a daily basis and residents are screened based on a daily basis. Appeal Rights Given.