Facility Evaluation Report

On 3/17/2022 starting approximate 10:20 a.m., Licensing Program Analyst (LPA) Catherine Lin arrived unannounced to conduct Infection Control Inspection. LPA met with staff Jonle Iroy and disclosed the purpose of the visit. Administrators, Shielha Muniz arrived at a later time.

During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. There is one central entry point for universal screening for staff, residents and visitors. Facility has a sufficient 2-day perishable and one-week non-perishable food supply. Facility has Mitigation Plan, Emergency Disaster Plan, and maintains record of routine screening for residents, staff and visitors.

· At 10:45 a.m., LPA observed milk and frozen meat expired the indicated used dates on packages. (2 gallons of Milk used by 3/11/22, Turkey Franks Sausage, 16oz package, 6 of them used by 9/24/21, 6 of them used by 9/20/21, 1 of them used by 11/11/21, 1 of them used by 1/6/22, 6 of them used by 1/27/22. Turkey Ham, 20oz package, 6 of them used by 8/4/21, 4 of them used by 8/16/21. Turkey Bologna 12oz package, 15 of them used by 12/4/21, 5 of them used by 2/9/22.)

The above deficiency was observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiencies by POC date may result in additional Civil Penalties.

Exit interview conducted with Administrator. LIC809D, Appeal Rights and a copy of this report provided.