Facility Evaluation Report

On 12/29/2022 at 9:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct an Infection Control Inspection. LPA met with Administrator, Ada Osuka and explained the purpose of the visit.

Upon entry, staff checked LPA's temperature prior to entry. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, living room, and outdoor areas. LPA observed sign & symptoms, cough etiquette, and social distancing were posted in the common areas. Hand washing posters were posted at bathrooms and sinks. Hot water was measured at 108.1 degrees F in the hallway bathroom sink.

During record review, LPA observed temperature logs for clients and staff. LPA observed facility has a copy of Mitigation Plan on file. LPA observed PPEs, food, and paper supplies were sufficient.

At 9:55AM, LPA observed C1's exit side door has a key dead bolt from the inside and was locked. LPA was informed that the key dead bolt was put in when C1 moved in the facility.

At 9:59AM, LPA observed unlocked scissors in the kitchen drawer. Administrator locked up the scissors during inspection.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided.