Facility Evaluation Report

On 8/26/2021 at 11:15AM, Licensing Program Analysts (LPAs) G. Luk and J. Sampair arrived unannounced to conduct an Infection Control Inspection. LPAs met with staff, Kaiona Urate and explained the purpose of the visit. Administrator, TJ Marcelo arrived 20 minutes later.

LPAs toured facility including but not limited to bedrooms, bathrooms, kitchen, and outdoor areas. LPAs observed sign & symptoms, cough etiquette, and social distancing were posted in the common areas. Hand washing posters were posted at bathrooms and sinks.

During record review, LPAs observed visitors log. LPAs observed facility has a copy of Mitigation Plan. LPAs observed PPEs, food, and paper supplies are sufficient.

The following deficiencies were observed during the visit:

-At 11:45AM, LPAs observed unlocked cleaning supplies and scissors in the kitchen. Unlocked gardening tool in the backyard. Staff locked up all items during inspection.

-At 11:50AM, LPAs observed kitchen cabinet doors and living room air vent was not in good repair. Administrator stated that those items will be repaired in the next couple days.

-At 3:30PM, LPAs observed facility sketch CCLD have on file is different than facility's physical plant. LPAs requested new sketch and permits from licensee.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiencies may result in Civil Penalties.

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