Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility and a designated Infection Control Lead.

Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains the required current liability insurance.

Continued on 809-C

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

Personnel Records-Training: Staff files are kept in a secure location. LPA reviewed 5 staff files. Files were reviewed for Criminal Record Clearance, Health Screening, Current First Aid and CPR as well as initial and ongoing training for care of the Elderly. No issues were observed. Administrator’s certificate is current until 10/10/27.

Resident Records-Incident Reports: Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Medical Consent, Admission Agreements, Identification & Emergency Information and Physician's Report. LPA reviewed Resident Files and deficiencies were observed. See 809-D

Residents Rights-Information: Residents are provided with telephone and internet at the facility. All the required postings were observed.

Planned Activities: Facility offers activities like games, food making, chair exercises, reading and a central TV viewing area for residents to enjoy together. There is an outdoor furnished patio area available for the residents.

Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Food was stored separately from cleaners, toxins and poisons. Appliances were observed to be operable and able to properly store and prepare food.

Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a locked room and are in their original containers. LPA reviewed 4 residents’ medications and there were no issues observed.

Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Emergency food and water were observed. Several flashlights and a full First Aid kit and Manual were available. The disaster plan was recently updated by Administrator but needs more detail. Administrator will send revised version to LPA. Disaster drills are conducted twice a year rather than quarterly per Administrator and a log of both drills was not provided to LPA. A deficiency was cited. See 809-D

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Facility maintains current Liability Insurance.

Due to time constraints the other Domains remaining in the CARE tool will be completed at a later date.

Per California Code of Regulations and Title 22, deficiencies were observed during today’s visit and are documented on the 809(D).

Administrator Kun Hu had to leave before the conclusion of the visit. Assistant Administrator Pinshi Liu assisted LPA with the remainder of the visit.

Exit interview was held with Assistant Administrator Pinshi Liu and a copy of this Licensing report was provided along with Appeal Rights