One new case of COVID positive reported in the facility today, incident report received RO. Jade stated there was a fire inspection today. They have added wifi to a TV to support staff in-service training's.

Line List reviewed. Residents are in the process of being reappraised by newly appointed Medical Director (MD). Resident one (R1) is receiving Hospice three times weekly and more frequently as needed for wound care when he removes his bandages, Hospice trained caregivers how to bandage R1. Resident two (R2) is receiving 1:1 care MD is working on appraising him to need a higher level of care refused to be seen by MD yesterday. Resident three (R3) is showing skin integrity problem, refusing repositioning every two hours, admitted to Hospice on 2/18/2021, new hospital bed and hoyer lift has been ordered, nurse will come three times per week, in service on care plan is scheduled for tomorrow. Resident four (R4) is still not compliant, MD will recommend conservatorship and will serve letter to comply with house rules, refused to be seen by MD yesterday. Resident five (R5) and Resident six (R6) are now out of quarantine. MD did not finish reappraisals yesterday and will continue to work with the facility to reappraise residents

Observed Kitchen. Fire Suppression System was last serviced on 2/1/2021 Knives observed locked and secured. Observed ample and properly stored foods with two days perishables and seven days non perishables. Fire extinguisher last served on 9/7/2020. Observed locked doors in the kitchen and knifes secured in locked kitchen.

Continued on 809

Observed dining room exit door alarmed. Residents were engaged in bingo maintaining social distancing and wearing masks. Tables were stacked and Designee instructed staff to move them. Designee stated the newly appointed Activity Coordinator is now doing morning exercises and they are creating activity schedule.

Observed employee area not locked, TM requested staff to lock the door and stated they will use the space for storage. Observed two restrooms out of order, TM stated plumbing is broken.

Observed stocked PPE station in lobby, donning and doffing signs posted.

Observed patio resident smoking area. Sanitizer available to the left of the exit door with COVID signs posted. Patio observed with four residents smoking. LPM recommended making sanitizer accessible outside and staff moved a table out and put sanitizer on it so residents can sanitize on their way back inside.

Dementia Care Plan of Operations to be submitted to the RO by 2/23/2021.

Signed 809 reports to be submitted to the RO by 2/19/2021.

Seven incident reports are being drafted and approved to be submitted to the RO by 2/19/2021.

LIC500 including Aya staff to be submitted to the RO by 2/19/2021.

Line List updates needed to be submitted to the (RO).

· Vaccination dates for staff to be submitted to RO by 2/19/2021.

· Residents reappraisal notes to be submitted to the RO by 2/19/2021.

Residents with updated Dementia diagnosis to be submitted to the RO by 2/19/2021.

An exit interview was conducted with Administrator. A copy of this report was provided to via email, due to COVID-19 precautionary measures, with a "read receipt" to verify the LIC 809 was received. Administrator is print out the report and fax a signed copy to LPA at 916-263-4744 or email to LPA at ashley.boothe@dss.ca.gov.