Routine inspection·January 12, 2023

Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. Infection Control inspection for this facility and was greeted by lead staff, Butch Apalisoc. Administrator Charmaine Mendaros was contacted and arrived later in the visit. The facility currently provides care for 5 residents 1 of which are receiving hospice services and some of which with a of diagnosis of dementia. LPA arrived at the facility and had temperature checked and logged. LPA continued with a tour of the facility with lead staff. Facility was at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 6/14/2021 at the time of the visit. Administrator will be contacting Suisun Fire Department to inspect and recharge the fire extinguisher. Smoke and carbon monoxide detectors were tested and found to be in working order. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations with food stored properly. Residents are provided various alternative food options per meal with the facility ensuring well balanced and nutritious foods. Residents were observed to be resting after lunch in their respective bedrooms. LPA observed hospice nurse also providing weekly services to residents in care with facility following proper visitation protocols. Toxins are stored in a locked cabinet in the facility garage and under kitchen and bathroom sinks. There was a supply of hygiene products and paper products available for resident use. All residents bedrooms have lighting & appropriate furnishings. Water at faucets accessible to residents in care were measured between 113.2 and 116.0 degrees F which is within regulation. LPA conducted a sample review of staff training and found that all staff have current CPR and 1st Aid training on file. Continued onto LIC809-C Infection Control: Facility has submitted an infection control plan for review. Posters have been placed at the front door, and facility has a station in the staff file closet near facility entrance with a sign in sheet, hand sanitizer and other items designated for visitors and staff. All staff and visitors were observed to have appropriate face coverings and following facility COVID protocols. Administrator Charmaine Mendaros's renewal Administrator Certification 6050432735 was received by the Department on 10/28/2022. Deficiency cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.