Non-compliance follow-up·September 30, 2022

Licensing Program Analyst (LPA) A. Canela arrived at this facility, unannounced, to conduct a Case Management Legal/Non-Compliance follow up visit. This inspection is being completed to ensure compliance with the Non-Compliance Conference dated, 11/5/2020. LPA met with Licensee/ Administrator, Cecilia Ganzon, and Aurelia Renta and explained the reason of the visit. LPA arrived at the facility and observed 3 residents sitting outside in the front area, with no staff present. The front area has tables, chairs and a covered area, but it is not gated. This area has a shared driveway, that is also used by private entity and the front leads two a main street. There are currently 13 residents living in the home and facility is licensed for a capacity of 17 residents with a Hospice Waiver approval for 4 of the residents, all non-ambulatory and no approval for bedridden. Staff working today were observed wearing mouth coverings. There is an entrance table with PPE supplies and staff screened LPA upon arrival. The facility has plenty of PPE available for staff and resident use. Water temperature in 2 bathrooms were within the required regulation of 105-120 degrees F. LPA went in all 9 resident bedrooms of the first level of the home and resident rooms were found free of odors as requested in non-compliance plan by CCL, for the facility to ensure it remains free of odors from incontinence. Auditory alarms were observed functional during this visit. LPA went over facility requirement to have workable signal system in all resident rooms. Deficiencies cited (see LIC809-D page) from Title 22, Division 6 of California Regulation. Failure to correct the deficiencies and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator, whose signature below confirms receipt of report. Due to printer issues, this report was emailed to Administrator. Appeal Rights Provided