Routine inspection·November 22, 2022

Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. Infection Control inspection for this facility and was greeted by staff, Rea Abenoja. Administrator, Bernadette Fabricante and Licensee and Lucita Gulapa arrived later during the visit. The facility currently provides care for 6 residents some of which with a of diagnosis of dementia and 4 of which receiving hospice services. LPA arrived at the facility and had temperature checked and logged. LPA continued with a tour of the facility with Staff and Administrator. Facility was at a comfortable temperature of 70 degrees F. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 6/13/2022 at the time of the visit. Smoke and carbon monoxide detectors were tested and found to be in working order. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Residents are provided various alternative food options per meal with the facility ensuring well balanced and nutritious foods. Residents were observed to be engaged with staff in the living room area participating in music and conversation. Toxins are stored in a locked cabinet in the facility garage and under kitchen sinks and found to be secured. There was a supply of hygiene products and paper products available for resident use. All residents bedrooms have lighting & appropriate furnishings. LPA conducted a sample review of staff training and found that all staff have current CPR and 1st Aid training on file. Continued onto LIC809-C Infection Control Facility has submitted an Infection Control Plan for review. Posters are located at the facility entrance, common areas and restrooms indicating COVID protocols and mitigation. Facility has a station at main entrance with a sign in sheet, hand sanitizer and other items designated for visitors, clients and staff. Staff and clients are also screened on a daily basis with routine testing for all staff conducted weekly. LPA requested the following documents be sent to CCL by COB 9/29/2022: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Copy of Administrator Certificate(s) Copy of Certificate of Liability Insurance No deficiencies cited during today's visit.