Routine inspection·April 26, 2022

Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct an Annual Required - 1 Year inspection and met with lead staff Maureen Canizares. 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 4 residents in care. Facility has a screening station with sign-in sheet and COVID questionnaire. Staff have CPR/first aid certifications. Fire extinguisher was charged and serviced 03/30/2022. The facility has a supply of PPE including gloves, hand sanitizer, N-95 respirators, gowns, face shields, and surgical masks. Staff have received and documented training on the following topics: infection prevention, symptoms, transmission and PPE use. Staff and Resident's temperatures are taken daily and documented. Caregiver Maureen stated staff clean and disinfect the facility throughout the day. LPA observed COVID-19 precaution postings, liquid hand soap and paper towels available in bathrooms. Administrator stated over the phone that N-95 mask fit testing for staff (Cal/OSHA requirement) is in process. 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 with caregiver: · Document verification of COVID Vaccination status or proof of negative COVID-19 test for indoor visitation LPA requested the following updated records to be submitted to Community Care Licensing by 5/23/2022 · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources (indicate 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. Exit interview conducted with Lead Caregiver Maureen Canizares , whose signature on this document confirms receipt. No deficiencies cited during this inspection