Routine inspection·January 30, 2023

"AMENDED' .. This is an amended version of the original report created on 1/30/23-SEE PG 2. Licensing Program Analyst (LPA) Alviso conducted a Required 1-Year visit, and met with Jose Acumabig, Administrator. The inspection is focused on the Infection Control procedures and practices of this facility. The facility has submitted the required" Infection Control Plan" to the Licensing Office, it's part of the facility's "Plan of Operation." All visitors are screened upon entering the building; All visitors have their temperatures taken and information is logged. Residents are screened daily, and observed for any changes, including a temperature check. All staff are screened before each shift, including temperatures taken, all information is logged. Currently twenty-five(25) residents in care, and one(1)resident receiving hospice care. Hospice care waiver is approved for ten(10) residents. The facility does not have a dementia plan of operation. Fire clearance approval is for forty-five (45) non-ambulatory. All exits were observed by the LPA to be free from obstruction. The facility fire extinguishers were serviced and tagged as required- expires 4/5/23. The two kitchen fire extinguishers were tagged-expires 1/2024. Facility offers activities during the day for those wanting to participate. The facility has a sufficient supply of personal protective equipment (PPE). Bathrooms observed had grab bars, and non-slip mat/flooring for bathing as needed. All postings were up and visible to all as required. LPA observed all staff wearing masks as required during LPA's inspection. Continued on LIC809C... All medications were locked up in the medication room, making them inaccessible to residents in care. All toxins/cleaners were locked up, making them inaccessible to residents in care. "AMENDED" The LPA toured the kitchen with the Administrator. Between approximately 10:35 am and 11:00 am, LPA and Administrator observed several plated bowls of fruit unattended in the dining room sitting out improperly covered/exposed on a service cart, observed lettuce and mayonnaise on the salad bar table in the kitchen and open commercial size bag of rice and commercial size box of beans open on the kitchen/pantry floor with no means to close the packages in order to prevent them from potential contamination. LPA was unable to verify how long trays of food and salad bar items had been improperly stored. The Administrator agreed with food storage concerns, and started working with the kitchen staff on a plan of correction during LPA's inspection. LPA obtained pictures for the file. The deficiency will be cited, General Food Service Requirements 87555(b)(9)-see LIC809D. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with the Administrator. Appeal rights provided .