Routine inspection·May 13, 2022

At approximately 12:30PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct an Annual Inspection visit and was greeted by Administrator, Emmanuel Salas. The inspection is focused on the Infection Control procedures and practices of this facility. Upon arrival at the facility, LPA had their temperature checked and logged. LPA answered a standard COVID-symptom questionnaire. LPA conducted a walk-through of the facility and observed the following: COVID-19 signs were observed at the entry way and throughout the facility. Hand-washing signs were observed in the bathrooms and at sinks. All staff present were observed to be wearing a mask. The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility has a cleaning and disinfecting schedule that occurs daily. Facility has at least a 30-day supply of Personal Protective Equipment (PPE) and medication for clients. Staff and Residents are screened daily for COVID-19 symptoms and it is logged into facility binders. Facility has a plan in place if a staffing shortage were to occur. Per Conversation with Administrator, Fire Extinguisher was newly bought last month. Fire alarm system and Carbon Monoxide detector were tested and operational. Continued on LIC-809-C Continued from LIC-809 LPA and Administrator discussed PIN 21-43-ASC regarding Mitigation Plans and PIN-22-13-ASC regarding Infection Control Plans. LPA requested the following documents to be submitted to CCL by Close of Business, Wednesday, 5/18/2022: Updated LIC 500 (Personnel Report) Updated LIC 999 (Facility Sketch) Administrator to provide copy of Fire Extinguisher Receipt During walk-through of facility, LPA observed that the staff room was unsecured and contained 5 bottles of over the counter vitamins and medications. LPA discussed the need to ensure staff rooms are secure to prevent situations like this. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Administrator and Appeal rights were given.