Routine inspection·December 21, 2021

Licensing Program Analyst (LPA), Katrina Walters arrived unannounced to conduct an Annual inspection and was greeted by Marketing Director, Aida Reye Santos (ARS) and Administrator Shelley R Reyes (SR) (6012578740 exp. 1/31/2022) arrived later. 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) 06/24/21. 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 via sign in application on an I PAD, which then prints a badge out for visitors. LPA toured the facility with ARS. SR joined the tour later. 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. Emergency contacts have been updated. Facility has procedures for testing and isolating all individuals who are showing symptoms. Facility keeps track of all resident, staff and visitors vaccination records in their appropriate binders. Facility has a 30 day supply of Personal Protective Equipment (PPE) and incontinence product supply. All staff have been fit tested for N95 mask, and have received training on COVID-19 exposure through Local Public Health and Kaiser Permanante. Common Areas are disinfected after usage, using disinfectant sprayers. Continued on 809 C LPA observed a visitor walking in common area without a mask. In addition, LPA disclosed to Administrator that facility staff failed to wear face covering while providing care and supervision to residents in this facility. S1 was observed transporting resident in common areas, and then observed not wearing a mask while providing care in residents bedroom. Facility failed to ensure staff followed COVID-19 precautions, CCL and CDC recommendations. In addition, LPA observed that the two studio resident bedrooms were conjoined in order to make one resident suite. In doing so, one of the studio doors were blocked. LPA requested that Administrator have the bedrooms cleared by the fire department. Administrator agreed to submit an updated facility sketch to the Vacaville fire department by 1/3/2022. The following deficiencies were observed (see LIC 809-D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted, copy of this report and appeal of rights provided ,