Routine inspection·February 6, 2023

Licensing Program Analyst (LPA) Ashley Smith conducted an unannounced required annual visit. Along with the annual visit, the purpose of today’s visit was to ensure the facility was maintaining substantial compliance as discussed in the Non-Compliance Conference that took place on 10/26/2022. As a result of the non-compliance conference, the licensee is placed on frequent monitoring for a period of two years. The LPA met with staff and explained the reason for the visit. KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Dining room furniture on both floors appeared to be in good condition. BEDROOMS: The LPA observed a randomly selection of resident rooms, and rooms were furnished appropriately with clean linens, furnishings and sufficient lighting. RESTROOMS: Restrooms were stocked with soap and paper towels. Water temperature was tested on the first and second floor, and temperature ranged from 105.3– 107.7 degrees Fahrenheit. Hand washing signs promoting good hand hygiene were observed in the common restrooms. COMMON SPACES: Upon entry to the facility, the Bistro area was unclean, as chips and trash was observed scattered on the grounds. At 9:10 a.m., the LPA observed a pile of empty water bottles and a soda can in the outdoor courtyard. At 9:15 a.m., the LPA observed trash (open cracker wrappers, ice cream) scattered on the counter in the upstairs kitchen/bistro area. At 9:16 a.m., an unknown substance was observed melted in the cabinet. In addition, there was a hat and sock in the cabinet of the 2nd floor kitchen/bistro area. At 9:20 a.m., the couch cushions on the 2nd floor balcony were observed to be unclean. The LPA walked through the facility at 11:21 a.m. The common space at the Bistro near the front entrance was clean and residents were occupying the kitchen/bistro area on the 2nd floor, yet the counters appeared to be clear. The empty water bottles observed in the downstairs courtyard were still present at 11:32 a.m. The LPA tested the delayed egress doors and doors were operable during the visit. EXTERIOR: The facility has several enclosed courtyards with appropriate outdoor seating for resident use. There were no bodies of water observed during today’s visit. FILES: The LPA reviewed a selection of staff files. Out of the seven (7) files reviewed, the LPA identified three (3) persons that were fingerprint cleared, but not associated to this location (Staff #1, Staff #2, Staff #3). Records indicate the staff have worked at the facility in excess of five days. This is an immediate civil penalty and civil penalties will be assessed in the amount of $100 per day for five days ($100 x 5 days) for S1, S2, and S3. INFECTION CONTROL: Staff were observed wearing appropriate face coverings. The facility continues to screen visitors and staff upon entry into the facility. The facility has an adequate supply of Personal Protection Equipment (PPE). Hand sanitizer was available for staff, residents and visitors. The facility can designate a section of the facility for isolation and quarantine purposes if the facility has a confirmed case of COVID-19. The facility keeps record of staff and resident vaccinations. The following deficiencies were observed (See LIC 809-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. Civil penalties assessed during today’s visit. Exit interview conducted. A copy of the report and appeal rights were provided.