Routine inspection·June 20, 2022

Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct an Annual Required - 1 Year inspection and met with Administrator Pritpal "Meenu" Atwal. The annual inspection is focused on the Infection Control procedures and practices of this Residential Care Facility for the Elderly. LPA toured the facility and observed 6 residents in care. Facility has a COVID-19 screening station (visitor sign-in sheet, COVID questionnaire, thermometer, hand sanitizer). Staff have current CPR/first aid certifications. Fire extinguisher was charged and bought new on 1/22/2022 (LPA observed receipt). The facility has a supply of PPE including gloves, hand sanitizer, N-95 respirators, gowns, face shields, and surgical masks. Staff and Resident's temperatures are taken daily and documented. Staff clean and disinfect the facility throughout the day. LPA observed COVID-19 precaution postings, liquid hand soap and paper towels available in bathrooms. 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. During this visit, LPA verified staff vaccination records for COVID-19. Report continued on LIC809-C LPA discussed the following requirements with Administrator: · Facility to obtain N-95 mask fit testing for staff (Cal/OSHA requirement) - Technical Advisory Note was issued to the facility during this visit. · Auditory Alarms must be on to monitory exits LPA requested the following updated forms to be submitted to Community Care Licensing by 07/11/2022: · 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. · Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475 ). The poster that is posted shall be 20" x 26" · Administrator to send vaccine verification to LPA for staff's vaccine records that were not in file. · Provide copies of physician's order for bed rail that extends from the head half the length of the bed to be used only for assistance with mobility for (R1 & R2) Reminder: Infection Control Plan due 06/30/2022 Exit interview conducted with Meenu Atwal, Administrator, whose signature on this document confirms receipt. Due to printer issues, this report was emailed No deficiencies cited during this inspection