Routine inspection·September 13, 2021

On 9/13/21 at 12:34pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the lead caregiver Ma Emelina Cabangal and explained the purpose of the visit. Administrator Voica Matis was not present and gave permission for Ma Emelina Cabangal to sign in her absence. LPA Bilger inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. Facility is a 4 bed residential care facility for the elderly with a current census of 4. There are 3 bedrooms. Two are private, one room is shared. There are 2 bathrooms for resident use. There is a separate living room/TV area and laundry room which leads out to the emergency exit path. No obstructions to emergency exits noted. LPA also conducted the infection control domain tool. The facility submitted a LIC 808 mitigation plan , which was approved. The facility has central entry point and has implemented screening and sign in procedures at the front door area. The facility conducts routine symptom screening for employees, residents, and visitors. LPA observed the facility to have hand washing, COVID - 19 informational, and social distancing signs posted throughout the facility, on the front door, and back yard. The facility has a designated infection control lead. The facility is able to designate and dedicated a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. Water temperature reads 113.5*F in the bathroom and room temperature reads 75*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 6/17/2021. Facility has an emergency food and water kit. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to lead caregiver Ma Emelina Cabangal.