Routine inspection·October 28, 2021

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced to conduct a Required - 1 Year inspection at approximately 12:20 PM, and met with staff, Dennis Panlican. Before entering the facility LPA asked COVID risk assessment questions to staff who indicated no one has been sick or exhibited symptoms of COVID within the last two weeks. Administrator, Caroline Ramos was not present at the time of the visit. LPA spoke with administrator on the telephone. Administrator gave direction to perform inspection with staff. The inspection is focused on the infection control procedures and practices of this facility. Upon entry LPA was screened for COVID symptoms and asked to sign in. At primary entrance LPA observed temperature logs and visitor sign-in sheet. LPA conducted walk through of facility with staff and observed COVID postings throughout. Mitigation plan has been submitted and approved by Community Care Licensing (CCL). Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer is kept throughout the facility. Per staff, infection contro guidelines and PINs are communicated to residents' families by administrator. Staff have completed Personal Protective Equipment (PPE) and infection control training through Kaiser. Staff have not been N95 fit tested. High touch surface areas are disinfected daily. Due to current facility census, residents could isolate in their own rooms if they became ill. LPA confirmed licensee has necessary PPE and supplies to support a resident in isolation. LPA requested to see temperature screening logs and determined they were current. Residents' emergency contact information has been updated. Toxins are secured and inaccessible in a locked garage cabinet. Medications are centrally stored in a locked cabinet located in the kitchen making them inaccessible to residents. Exit alarms on exit doors were working properly. (Continued on LIC 809-C) At approximately 12:50 PM while touring facility with staff, LPA observed resident bedroom being used for storage. LPA observed seven boxes with incontinence briefs and bottled beverages along the wall under the bedroom's window. Staff stated that the boxes arrived today and that he would move them today. LPA provided guidance to remove boxes and to ensure the upkeep of general storage space to avoid the use of bedrooms as storage space. Staff removed boxes before the end of the inspection. Facility is allowing residents to have meals in the dining room and furniture is set up for social distancing. Visitation is encouraged outside but is allowed inside. LPA requested the following documents be submitted to CCL by November 5, 2021. LIC 308 Designation of Facility Responsibility Liability Insurance LIC 500 Personnel Report Emergency Disaster Plan LIC 9020 Client Roster Exit interview conducted with staff and a copy of this report was printed for the administrator. No deficiencies cited during this inspection