Post-licensing visit·October 29, 2021

Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct a Post-Licensing inspection and met with Licensee Ceazar Camerino, and Licensee & Administrator Anny Camerino who arrived later. The inspection is focused on the Infection Control procedures and practices of this Residential Care Facility for the Elderly. LPA conducted a walk-through of the facility with Licensee and observed a COVID-19 screening station at front entrance of the facility to screen anyone entering (staff, essential and non-essential visitors). Screening station includes hand sanitizer, a thermometer, COVID-19 screening questionnaire, and a sign-in sheet for visitors and staff. LPA observed 1 resident in care. Licensee stated staff clean and disinfect the facility two - three times a day and as needed. A designated visitation area is available and staff provide phone calls for family to stay in contact with residents. There is a supply of PPE including gloves, face shields, N-95 respirators, and surgical masks. 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. Licensees wore masks during this visit. LPA discussed the following with Licensees: · Documenting vaccination status (and/or negative COVID test taken within 72 hours) for visitors and staff entering the facility. · Requirements and guidance from Provider Information Notice (PIN) 21-40-ASC. · Daily temperature checks & documentation for residents and staff. · N-95 respirator Fit testing (Cal/OSHA requirement) for staff. · Documenting staff training on infection prevention, symptoms, transmission and PPE use. · Locked storage requirements for medication, disinfectant and cleaning solutions. · Fire safety and clearance request of approval from CCL to lock exterior doors or perimeter fence gates. · Emergency Disaster Drills to be conducted every 3 months. · Fire extinguisher to be tagged (service date) by the fire department. · CCL COVID-19 precaution postings (LPA to send copies to licensee). LPA provided the regulations for the above requirements. Exit interview conducted with Administrator, whose signature on this document confirms receipt. No deficiencies cited during this inspection