Routine inspection·October 24, 2022

License Program Analyst (LPA) Farhaan Sarangi arrived unannounced to conduct a Required – 1 year inspection at Pacifica Senior Living Vacaville. LPA was welcomed by front desk staff, and was granted access into the facility. LPA met with Administrator, Jeffery Gollihar LPA toured the facility with the Administrator. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be last charged on April 2022 at the time of the inspection. Facility smoke detectors are hard wired and sound directly to the fire station. Fire drill, Smoke detectors and fire sprinklers are inspected, and inspection records are current with the last inspection being conducted on April 26, 2022 with the next inspection dated for October 26, 2022. Last Disaster drill was conducted on July 7, 2022. There are emergency lights in many of the fixtures in the common areas of the facility that come on should a power outage occurs. Hot water temperature measured at 115 degrees, within Title 22 acceptable regulation of 105 to 120 degrees F. The facility serves residents with dementia and has a plan of operation for special care and programming. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations at the time of the inspection. There are special provisions made for individuals with special dietary needs. There was a supply of cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents in the common areas at the facility were supplied with individual paper towels and hand soap dispensers. Bathrooms in resident’s rooms have a towel and soap. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. A sample tour of resident’s bedrooms were conducted, and bedrooms inspected have lighting and appropriate furnishing. Medication cart in the facility medication room at the facility was also locked. Toxins are stored in a locked housekeeping room. First Aid kit was inspected and found to be appropriate during the inspection. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms or COVID-19 + in the facility. Facility has PPE supply stored in the storage container outside of the facility. Facility is in the process of obtaining N95 Fit testing. (Report continued on LIC 809C) LPA requested the following documents to be sent: LIC 500- Personnel Report LIC 308- Designation of Responsibility LIC 309- Administrative Organization LIC 400- Affidavit regarding Client Cash Resources Updated facility sketch Updated Emergency Disaster Plan (LIC 610D) Surety Bond Most up-to-date Liability insurance Control of Property Register of residents No deficiencies were observed or cited during today's Required 1 year inspection. Exit interview was conducted and a copy of this report was emailed to the facility Administrator due to printer issues.