Routine inspection·November 15, 2021

Licensing Program Analyst (LPA) Victoria Willis arrived unannounced to conduct an Annual Required inspection and was greeted by caregivers. Administrator, Romulo Bautista was available by phone and LPA received permission from them to have caregiver, Leilani Gambol sign report. The inspection is focused on the Infection Control procedures and practices of this facility. Upon arrival, LPA was screened by caregiver and screening was documented. LPA initiated a walk-through of the facility with caregiver around 2:00pm and observed the following: Facility has COVID-19 posters throughout that included hand washing signs in bathrooms and general Covid-19 information at the front entrance. LPA confirmed with caregiver that they are conducting vaccine verification for visitors per Provider Information Notice (PIN) 21-40-ASC. Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer is located throughout common areas of the facility and in some bathrooms. Other hand-washing supplies were also observed in bathrooms. Observed staff had masks on during this visit. Commonly touched surfaces are disinfected at least once per day and after use. Facility maintains documentation of staff and resident daily temperatures. Facility has a designated visitation area outside and is allowing for visitation in resident rooms. Staff have completed PPE training but have not been N95 fit tested. LPA discussed getting staff fit tested with Administrator. Facility has submitted and CCL has reviewed their Covid Mitigation Plan. Facility has more than a 30 day supply of Personal Protective Equipment (PPE) including but not limited to masks, gowns and hand sanitizer. Facility maintains a 30 day supply of medication. Caregiver and LPA discussed their Emergency Disaster Plan. Fire extinguishers have been serviced within the last year. Hardwired combination smoke/carbon monoxide alarm system was tested and operational during inspection. No deficiencies cited during this inspection.