Post-licensing visit·July 22, 2021

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility to conduct a Post Licensing visit. LPA observed construction in the front lobby, so there is an alternate entrance and front desk set up nearby. Upon arrival, front desk staff conducted a COVID-19 screening and contacted the Administrator Robert Gutierrez. Entrance interview conducted. LPA, along with Administrator, 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. Today's evaluation included, but was not limited to, building and grounds, resident rooms, bathrooms, common areas, personal accommodations, hot water temperature in resident bathrooms, kitchen and food supplies. Currently the facility is undergoing renovations; LPA and Administrator conversed extensively about the plans to minimize resident impact during construction. There is an adequate amount of perishable and nonperishable foods. LPA observed fire extinguishers recently serviced and fully charged. Centrally stored medicines are kept in a locked medication room. First Aid kit is complete. Grab bars were present in the bathrooms. LPA observed appropriate and sufficient furnishings and lighting in each room. Hygiene items are being provided. Administrator provided documentation of fire alarm system testing, which took place on 7/15/2021, with no functional defects found. LPA observed disaster plan posted hallway. LPA observed COVID-19 postings throughout the facility. LPA observed a 30-day supply of PPE. LPA reviewed a sampling of resident medications and records. LPA reviewed a sampling of staff records. During facility tour, in the Memory Care unit, at 12:17PM, LPA observed a can of Febreze air freshener in Resident #1 (R1)’s room. At 12:20PM, LPA observed Neutrogena face wash and 2 (two) tubes of toothpaste in Resident #2 (R2)’s room. Both rooms were observed unlocked and located in the Memory Care unit. During a review of resident records starting at 1:17PM, LPA observed that some resident Admissions Report Continued on LIC 809-C Agreements have not been updated since the Change of Ownership took place on 5/1/2021. 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. Today's reports and appeal rights were reviewed and emailed to the Administrator.