Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived at this facility unannounced to conduct an annual inspection visit. LPA Valerio introduced herself, explained the purpose of the visit, and was met by facility staff. LPA Valerio was screened for COVID-19 symptoms with temperature prior to being allowed inside the facility. Staff confirmed zero residents and staff have displayed any signs or symptoms of COVID-19 in the last 10 days.

The physical plant was toured inside and outside to ensure the safety of the residents and compliance with Title 22 regulations. LPA also conducted the infection control domain tool. The facility has an approved LIC 808 mitigation plan on file. The facility has one central entry point and has implemented screening and sign in procedures at the front of the home. LPA observed the facility to have hand washing signs posted at the front door and throughout the facility. The facility is able to designated and dedicated a COVID-19 bedroom and bathroom if needed.

LPA observed the temperature inside the facility was measured at 72 *F, which is within the required range of 68 degrees F and 85 degrees F. The hot water was measured at 108.9*F, which is not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C) as per Title 22 regulations. Facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. LPA observed the centrally stored medications area and cleaning supplies to be locked and inaccessible to clients. Resident rooms was sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguishers was up to date with last check on 11/18/2021. LPA Valerio requested Licensee Rosemarie to send updated Administrator certificate for Angelo once renewed, LIC 500, and LIC 610

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held with facility staff, Licensee Rosemarie was informed via cell, and a copy of the report was left at the facility .