Routine inspection·June 2, 2022

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 2:00PM. This annual had a specific emphasis on infection control practices and procedures. The LPA met with Licensee Gulira Atakeeva and discussed the reason for the visit. The LPA, along with facility 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, living room and dining room furniture was observed to be in good condition. A fireplace was observed to be covered and inaccessible to residents in care. The LPA observed the required postings in the common area. Fire extinguishers were observed to be fully charged and last serviced 02/11/2022. 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 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 private resident rooms and 1 (one) is a shared resident room. The upstairs area is designated for staff use only and was gated rendering it inaccessible to residents in care. Report Continued on LIC 809-C RESTROOMS: The LPA observed 4 (four) restrooms in the facility; 1 (one) is a shared restroom, 2 (two) are private restrooms and one is designated for staff and guests. Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. Water temperature in the shared resident restroom measured at 134.0 degrees Fahrenheit at 2:28PM and 125.2 degrees Fahrenheit at 3:12PM after adjusting the water heater and a private resident restroom's water measured at 125.8 degrees Fahrenheit at 3:14PM. INFECTION CONTROL: During today’s visit, the LPA spoke with the Licensee 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 has previously managed COVID-19 active cases and the facility complied with all requirements set forth by the local health department and licensing. Staff are up to date regarding guidelines pertaining to visitation and vaccine requirements. The facility’s policies and procedures as it pertains to infection control are adequate. 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. Exit interview conducted. A copy of the report was provided via email.