Routine inspection·January 17, 2023

Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct an Annual Required - 1 Year inspection and met with Irene Monteclar, Administrator . The annual inspection is focused on the Infection Control procedures and practices of this Residential Facility for the Elderly. LPA toured the facility with House Manager Jasmine Aliscad; all exits were unobstructed. The facility was found to be clean and at a comfortable temperature. Facility has a COVID-19 screening station and an ample supply of PPE. Staff have current CPR/first aid certifications in file. Fire extinguisher was charged and serviced 09/14/2022 . LPA observed COVID-19 precaution postings, liquid hand soap and paper towels available in bathrooms. The facility has submitted their Infection Control Plan to the California Department of Social Services, Community Care Licensing. LPA verified staff COVID-19 vaccination records. LPA verified documentation on N-95 Respirator FIT testing for staff (Cal/OSHA requirement) was completed. All staff wore face masks during this visit. LPA requested the following updated forms to be submitted to Community Care Licensing by 02/17/2023: · LIC 308 Designation of Facility Responsibility (1 person per form) · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources (indicate if not handling cash for residents) · Copy of surety bond · 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 Administrator, whose signature on this document confirms receipt. ***No deficiencies cited during this inspection