Routine inspection·June 13, 2022

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required inspection and met with individual (I1) and Administrator Charito Santos. Licensee Nick Aquino arrived later. LPA/Administrator reviewed PIN 22-07, 22-09, 22-13, 22-15 and 22-16. LPA arrived at the facility and had their temperature checked and logged into a sign-in sheet. LPA observed that facility has posters on the front door indicating visitors about updated visitor's policy to protect residents in care. Once inside the facility, LPA observed that staff were wearing masks during this visit. At approximate 9:30am LPA learned through interviews with staff that individual ( I1) had been working providing care and supervision to residents in care for one day and has not been associated to the facility yet, LPA informed Licensee that individual (I1) is fingerprint, but they are not associated to the facility and should never be working and providing care to residents prior to a criminal record clearance or exemption. LPA/Administrator conducted a walk-through of the facility and observed approximately 9:35am expired food. There was 16 boxes of expired cake mix, 2 boxes of value size expired Cheerios cereal, 3lbs of expired sour creams, 1 expired cranberry jelly and an expired bag of bread rolls. Hand sanitizer were observed in the common area of the facility. Facility bathroom are kept stocked with hand hygiene and paper products. Commonly touched surfaces are disinfected at least twice a day. Facility is able to accommodate a single room for each resident that needs to isolate and is able to serve meals and deliver medications. Facility staff have been trained on PPE protocols and N-95 fit tested. Staff and residents are being monitored daily and results are documented. Facility maintains a 30 day supply of medication. Facility has a 100% vaccination rate and received boosters for staff and residents. Residents do not typically wear a mask while in the facility, but they do wear masks when in the community. Residents are able to receive indoor visitation with their families and facility is able to perform antigen tests to visitors as well as screening, documenting for symptoms and tracking purposes. Continues on LIC809C... Continued from LIC809... Facility has submitted their Covid Mitigation Plan and approved on 5/19/21. Facility has more than a 30 day supply of Personal Protective Equipment (PPE) including masks, face shields and hand sanitizer. PPE supplies are accessible for staff. Licensee will provide updates of the following by 6/27/22: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), Liability insurance and Emergency Disaster Plan (LIC610E). Deficiencies 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. Civil penalties are being assessed in the amount of $100 per day for allowing a person to work, reside or volunteer in the facility without a fingerprint clearance exemption.