Routine inspection·August 13, 2021

Licensing Program Analyst (LPA) Cuadra arrived unannounced, to conduct an Annual Required inspection and was greeted by staff and Licensee, Josephine Mendoza arrived later. The inspection is focused on the Infection Control procedures and practices of this facility. LPA conducted risk assessment call with Licensee prior to the visit. Administrator and LPA discussed the Emergency Disaster Plan. Upon arrival, LPA observed that facility has posters on the front door indicating that visitors are not allowed. LPA discussed visitation with licensee who stated that residents receive visits from their responsible party and there is a designated living room for visitation and are documenting screening questions. Once inside the facility, LPA observed that facility does have a sign-in for visitors and did screen LPA when they came in. LPA observed that staff were wearing masks during today's visit. LPA conducted a walk-through of the facility and observed Covid-19 posters that included hand washing signs in restrooms. Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer was observed throughout the facility. Residents are encouraged to wear masks when in the community. Commonly touched surfaces are disinfected throughout the day. Facility has a designated isolation apartment on the facility premises. Facility staff have been trained on PPE protocols but have not yet been N-95 fit tested. Facility has submitted their Covid Mitigation Plan and it was approved on 7/28/21. Facility has more than a 30 day supply of Personal Protective Equipment (PPE) including but not limited to masks, face shields, gowns and hand sanitizer. PPE is in a location that is stored and accessible to staff. Facility maintains a 30 day supply of medication. Facility has a 100% vaccination rate of staff and residents, but still conducting surveillance test. Per Licensee, she has reviewed latest PINs 21-32 ASC and 21-33 ASC. LPA provided the following guidance: Get staff N-95 fit tested. No deficiencies cited during today's inspection