Post-licensing visit·August 27, 2021

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct a Post Licensing Inspection and met with Leilani Gambol, House Manager and Manolito Tolentino, Care Staff . The annual inspection is focused on the Infection Control procedures and practices of this Residential Care Facility that has 5 residents. LPA observed a screening station at the entrance of facility which had hand sanitizer, a thermometer, and a sign-in station for visitors. Visitors are screened for COVID-19 symptoms (including temperature check) upon arrival to the facility. Staff and clients' temperatures are taken at least once a day and are documented. LPA conducted a walk-through of the facility with House Manager and observed COVID-19 precaution postings at the entrance to building,. LPA observed facility was a comfortable temperature. Fire Extinguisher was up to date (last serviced on 08/19/2021) and easily accessible. All Fire Alarms are hardwired and operational. LPA randomly tested water temperature at the facility and it was within regulation. All exits were unobstructed and doors were operational, with auditory alarms on all external doors. Staff clean and disinfect the facility daily. High touched surface areas are disinfected after each use. The facility allows visitation in resident's private rooms with masks or outside with masks, and provides virtual visits and has a house phone. Facility is in process of N-95 Respirator Fit Testing. LPA observed a supply of PPE including: gloves, face shields, N-95 respirators, surgical masks and gowns. All staff wore a face mask during this visit. Staff are current on the CPR and First Aid training. The facility has submitted a COVID-19 Mitigation Plan Report on Epidemic Outbreaks specific to COVID-19 to the California Department of Social Services. Exit interview conducted with Leilani Gambol, House Manager, whose signature on this document confirms receipt. No deficiencies cited during this inspection.