Routine inspection·January 24, 2023

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 01:05PM. This annual had a specific emphasis on infection control practices and procedures. The LPA initially met with staff Eufrecina Tabuena. Licensee Maricar Lee arrived at the facility at 01:13PM and discussed the reason for the visit. Entrance interview conducted. The LPA, along with Licensee, toured the physical plant areas inside and outside at 01:15PM to ensure there are no health and safety hazards. The following was observed: BEDROOMS : The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 5 total bedrooms – one (1) bedroom is shared for resident use and four (4) are private. RESTROOMS : 3 restrooms 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. At 01:27PM, in a common hallway restroom, water temperature measured at 125.6 degrees Fahrenheit. 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. The LPA observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year. Hardwired smoke detectors and carbon monoxide were tested at 01:30PM and Report Continued on LIC 809 - C were functional at the time of the visit. The backyard has a covered outdoor area equipped with furniture for resident use. There were 2 (two) water fountains noted, neither of which were running, but both did contain some standing water. Facility representative noted water had accumulated during the recent rains and that both would be drained to ensure resident safety. The garage was observed locked and contained locked storage cabinet for laundry supplies and emergency food supply. 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. INFECTION CONTROL: During today’s visit, the LPA spoke with the Licensee regarding the facility’s infection control practices. 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 observed an adequate supply of Personal Protective Equipment (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 deficiency was observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.