Routine inspection·February 24, 2022

Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct an Annual Required - 1 Year inspection and met with Rosemarie Vister, Live-in staff. The annual inspection is focused on the Infection Control procedures and practices of this Residential Care Facility for the Elderly. LPA conducted a walk-through of the facility with live-in staff and observed COVID-19 precaution postings. The facility has designated visitation areas for visitors. Staff and resident's temperatures are taken once a day. Rosemarie stated staff clean and disinfect the facility everyday. LPA observed 5 residents in care. The facility has a supply of PPE including gloves, face shields, N-95 respirators, surgical masks and disposable gowns. Staff have completed training with Solano Public Health on 2/10/22 on the following topics: infection prevention, symptoms, transmission and PPE use. The facility has submitted a COVID-19 Mitigation Plan Report on Epidemic Outbreaks specific to COVID-19 which was reviewed by the California Department of Social Services, Community Care Licensing. LPA discussed the following requirements related to COVID-19 precautions with Rosemarie Vister, live-in staff: · Documenting Resident and staff daily temperatures. · Screening station at front entrance of facility to include a COVID-19 screening questionnaire · Verifying COVID-19 vaccination or COVID-19 test for indoor visitation per PIN 22-07-ASC · N-95 respirator Fit testing (Cal/OSHA requirement) for staff. Administrator to obtain documentation for completion for CCL verification. · Staff to wear face masks indoors regardless of vaccination status Report continued on LIC809-C LPA observed the following unlocked & accessible medication during the inspection (photos taken): · 2 boxes containing 4 single-dose medication injection pens belonging to staff (S1) observed in the refrigerator · Clear pill box container containing 10 individual medication pills belonging to resident (R1) observed on the kitchen counter · 4 boxes containing topical and 1 nasal medication for residents (R2 & R3) observed in the hallway closet The facility received a citation for the deficiency observed above. Appeal rights given. California Code of Regulations, (Title 22, Division 6), are being cited on the attached LIC 809-D. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Rosemarie Vister, live-in staff, whose signature on this document confirms receipt.