Routine inspection·February 16, 2023

Licensing Program Analyst (LPA) Karina Canela arrived for the purpose of conducting a Required -1 Year inspection and met with Ed Gadia, co- administrator . The annual inspection is focused on the Infection Control procedures and practices of this Residential Care Facility for the Elderly. LPA toured the facility, all exits were unobstructed, and the facility was found to be at a comfortable temperature. Facility has a COVID-19 screening station. Fire extinguisher was charged and serviced 07/29/2022. The facility has a supply of PPE. LPA observed COVID-19 precaution postings, liquid hand soap and paper towels available in bathrooms. There are 9 smoke detectors which were tested & observed operational. LPA reviewed resident files during this inspection. The facility has submitted their Infection Control Plan to the California Department of Social Services, Community Care Licensing. All staff wore face masks during this visit. Co-administrator to obtain documentation for completion of N-95 respirator Fit testing (Cal/OSHA requirement) for staff for CCL verification. LPA requested the following updated forms to be submitted to Community Care Licensing by 03/16/2023: · LIC 308 Designation of Facility Responsibility (1 person per form) · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources (indicate if not handling cash for residents) · Copy of Liability Insurance · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents · Copy of current Administrator's Certificate · Copy of current Lease/Rental Agreement or Property Tax document showing control of property. Exit interview conducted with co-Administrator, whose signature on this document confirms receipt. *No deficiencies cited during this inspection