Routine inspection·November 22, 2021

Licensing Program Analysts (LPA) Ruth Wallace conducted an unannounced visit to this facility to conduct an annual required inspection. LPA explained purpose of visit with Administrator Kim Viviano. Administrator Certificate #6044713740 expires on 6/27/2023. The facility is licensed for a capacity of 125 and has a hospice waiver for 28. There are currently 102 residents who reside at this facility and 20 residents on hospice. The LPA toured the facility with the administrator Kim Viviano on 11/22/2021 at 9:45 am. The facility kitchen is sanitary and contained 2 days of perishable and 7 day of non-perishable food supply. Water temperature is 107.3 degrees measured in Resident Room #133.. Kitchen fire extinguisher expires on 02/03/2022. Building #1 - 2345 Fire Extinguisher expires 09/16/2022. Building #2 - 2325 Fire Extinguisher expires 02/03/2022. LPA reviewed 6 resident bedrooms and all were sanitary and furnished. Furniture was in good repair. LPA observed carbon and smoke detectors and night lights throughout facility hallways. The last fire drill was on 11/11/2021. The facility buildings have a natural disaster plan. LPA reviewed 2 medication files. All medication files were up to date. Facility has complete first aid kits. LPA reviewed 4 resident files. All resident files were complete. LPA reviewed 1 employee files. All files were complete. The following documents needed to be submitted to licensing by January 11, 2022: Current Administrator Certificate, and a copy of Liability Insurance LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan As a result of this visit, no deficiencies were cited, per California Code of Regulations, Title 22 and Health and Safety Code. Exit interview conducted and a copy of report given to administrator