Routine inspection·December 2, 2021

Licensing Program Analysts (LPA), Katrina Walters arrived unannounced to conduct an Annual inspection and was greeted by Licensee/Administrator, Eileen Saddi (ES) (6012096740 exp. 3/18/2022) . LPA conducted a risk assessment prior to entering the facility. The inspection is focused on the Infection Control procedures and practices of this facility. This facilities COVID-19 mitigation plan has been submitted and approved by Community Care Licensing (CCL). Prior to entering, LPA observed that COVID-19 signs and the visitors policy were posted on the front door. Upon entry, LPA was screened for COVID-19 symptoms and had temperature checked. Alcohol based hand wash and disposable face mask were available for visitors. LPA conducted a walk through of facility with ES and made the following observations: Signs were posted through out the facility to promote social distancing and hand washing. The facility was clean and a comfortable temperature. In the event of an outbreak, both residents have their own room and will be isolate symptomatic residents. Facility has a 30-day supply of medication, incontinence products and personal protective equipment (PPE). Bathrooms used by residents are stocked with paper products and liquid hand soap. Staff have increased the monitoring of residents to check for COVID-19 symptoms. Per ES, all staff were vaccinated, but ES was unable to provide a copy of staff vaccination or records. ES understands that they are to keep records of all staff vaccination records in accordance to public health orders. ES will submit an updated copy of R1's hospice care plan, which includes a plan for full bed rails as required per regulation 87608(5)(B). In addition to S2's: LIC9052, and copy of their vaccination record. ES to submit to CCL Rohnert Park attention LPA Katrina Walters by 12/09/21. No citations during today's visit.