Routine inspection·October 18, 2022

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 12:06PM. This annual had a specific emphasis on infection control practices and procedures. LPA initially met with facility staff Hilda Alvarado. Licensee Mirvat Yacoub was contacted via telephone and arrived at the facility at 12:33PM. Entrance interview conducted. The LPA, along with Licensee, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, family room, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. Garage contained the laundry area, as well as emergency food supply, and storage . KITCHEN : Kitchen appliances appeared to be 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. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 5 (five) total bedrooms; 4 (four) are for resident use and 1 (one) is designated as a staff room. RESTROOMS: The LPA observed 2 restrooms in the facility; one is a shared resident restroom and one is a private resident restroom. Resident restrooms are clean and sanitary and in operating condition with grab Report Continued on LIC 809-C bars and non-skid surfaces. Water temperature was checked in resident restrooms and at 12:37PM water in the shared resident restroom measured at 125.4 degrees Fahrenheit. INFECTION CONTROL: During today’s visit, the LPA spoke with the Consultant regarding the facility’s infection control practices. Upon entry, the facility has a central entry point for symptom screening. LPA observed all staff and visitors to be wearing masks. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed. 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. RECORD REVIEW: Began at 12:16PM. LPA observed 2 staff working in the facility. Staff #1 (S1) indicated they have been working at the facility for over 6 months. Review of the Guardian background system revealed S1 does not have fingerprint clearance associated to the facility Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted with Consultant/Designee Anna Fabregas. Today’s reports and appeal rights were reviewed and provided via email.