Routine inspection·February 14, 2022

Licensing Program Analysts (LPA) Angel Ascencio arrived at the facility unannounced to conduct a required annual visit at 2:00 p.m. This annual had a specific emphasis on infection control practices and procedures. The LPA met with Administrator Adelaida Cruz and discussed the reason for the visit. Entrance interview conducted. The LPA, along with Administrator, toured the physical plant areas inside and outside at 2:45 p.m . to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 7 total bedrooms – six (6) bedrooms are private for resident use, and one (1) staff room. RESTROOMS: 3 r estrooms were observed to be clean and sanitary and in operating condition. Showers were also observed to have grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products in each restroom, as well as hand washing posters. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social distancing. The LPA did not observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year. Smoke detectors and carbon monoxide was observed to be in operable condition at the time of visit. The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. The garage was observed locked and contained the emergency food supply and locked storage cabinet for laundry supplies. Continued on LIC 809 - C KITCHEN : Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. Admin stated they are still waiting on the construction company for permit to finish remodeling the kitchen. INFECTION CONTROL : During today’s visit, the LPA spoke with the Administrator regarding the facility’s infection control practices at 3:00 p.m . There is 1 entry into the facility. Upon entry, the facility has a central point for symptom screening. LPA noted that the facility is allowing visitors for both indoor and outdoor visitation. The LPA did not observed an adequate supply of Personal Protective Equipment (PPE). The Admin stated they have PPE at home and will be bringing to facility. They will reach out to case LPA if in need of additional PPE. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate. The following recommendations were made: - Post PINs and educate staff, residents, and families on changing policies and procedures from the Department - Required COVID - 19 poster, cough etiquette poster, etc. - PPE LPA inspected water temperature for kitchen, and two (2) restroom. Water temperature exceeded range of 120 degrees F. Admin stated they will lower temperature. The following deficiencies were observed (See LIC 9099-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. One (1) citations was issued during today’s visit. Exit interview conducted. A copy of the report and appeal rights was provided via email.