Routine inspection·August 11, 2021

Licensing Program Analysts (LPA), Katrina Walters arrived unannounced to conduct an Annual inspection and was greeted by staff. Administrator, Al Q Balbuena (6029935740 exp. 3/11/2022) 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). Upon entry, LPA was screened for COVID-19 symptoms and had temperature checked prior to entering. Alcohol based hand wash was available for visitors. All staff are screened daily, daily screenings are logged in a facility binder. LPA conducted a walk through of facility with S1 and made the following observations: Facility had all required postings visible for visitors. Additional posters were posted throughout the facility to promote hand washing and social distancing. Bathrooms were stocked with hand soap and paper towel. Per Administrator all Staff have completed Personal Protective Equipment (PPE), infection control training. Facility has 30+ day supply of PPE, medication and incontinence supplies. Facility is cleaned daily and high touch surfaces are cleaned each shift and after every meal. Facility was a comfortable temperature and exits were free from obstructions. Fire Extinguisher was found to be last charged on October 23, 2020 at the time of the visit. All Facility smoke detectors and carbon monoxide detectors that were found to be functioning properly at the time of the visit. Continued on 809 C LPA is requesting the Administrator submits the following to LPA Walters by 8/16/21: A copy for residents R1's medication prescription. No deficiencies observed or cited during today's Required 1- Year inspection.