complaint·July 10, 2021

** This is an amended version of the original report delivered on 7/10/2021 and replaces the original report.** 1) Facility is in disrepair. Based on statements and service reports obtained on 7/9/2021, facility air conditioning unit is not working properly. Facility service reports indicate that the air conditioning blower for the backside of the facility is not working properly and requires a replacement. The service report also indicates that the air conditioning unit in the kitchen is requires a recharge of "freon". LPA Johnson and LPM Munoz observed that only 4 air vents in the facility was operational. 2) Facility has roaches. Based on observations from facility visit on 7/9/2021, LPAs Cheng and Singh observed cockroaches in resident room #17 and #16. R1 in room #16 confirmed that there were cockroaches in the resident bathrooms. LPA Singh observed cockroaches in facility kitchen areas on 7/9/2021. 3) COVID Protocols not followed: Screening and mask wearing. Based on statements obtained and document reviewed on 7/9/2021, LPAs Cheng and Singh observed that facility was not documenting staff and visitor responses to symptom screening. Facility documents show that the last documented symptom screening was dated in 5/2021. Facility was cited for failure to follow COVID protocols during LPAs Cheng and Singh visit on 7/9/2021; CCR 87468.1(a)(2). Based on LPAs and LPM information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED . California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. Exit interview conducted and a copy of report was provided along with appeal rights.