11positive off site positive and 7 deaths.

Licensing Program Manager (LPM) Liza King conducted a Case Management visit as a result of the facilities COVID positive status, ongoing concerns with safe practices and follow up regarding Incident Reports. LPM King, Temporary Manager (TM) Maria Canteria and Jade Parker Administrator (ADM) participated in a conference call on this date at XXXXXpm.

As it relates to COVID the facility reports from the line list today 50 positive residents, still a discrepancy of one resident from what has been reported to the RO reconciled against the facility list. No additional positives reported since last weeks results tested the 17^th, results on the 19^th of two new positive residents, one of which is still hospitalized, and it is reported that she will not be returning per families wishes. One positive resident onsite and reported to have no symptoms. No current positive staff. Mass testing of staff and residents weekly. Test conducted today of staff. Since the facility has identified 15 residents that are currently refusing testing, continued training needs to be provided to the staff re PPE donning and doffing, handwashing and disinfecting. All residents have received their first dose of the vaccine and some staff have received their second dose. No additional PPE needs were addressed at this time. All residents have an updated reappraisal that has been completed within the past week. Three residents are currently on hospice with recommendations from Dr. Golden of four more (total 7 current waiver 10). Facility is using TM staffing and staffing provided by DPH (Aya). Current contract with Aya staffing is set to expire for all staff beginning next week through March 18^th. Requests from the RO to provide a staffing plan in the absence of the additional aya staff. The TM is currently recruiting and will be conducting a job fair. Requests were made for the department to pay for fingerprints to be completed for new staff, TM was advised that this should be billed to the licensee or the employee can pay out of pocket.

During the call, the TM reported that the facility sewage had backed up and was coming up out of the floor drain in the kitchen area. LPM observed per video sent the area and saw the kitchen floor wet, the staff member present reported that the floor drain had sewage coming up from it and running out all over the floor. Rotarooter was present in the building during the case management visit. The RO requested a copy of the completed work order to be sent via email to AshleyBoothe@dss.ca.gov no later than 02/25/21.

The TM also reported that the water heater is in disrepair and that the staff are heating water on the stove as a result of the faucets in resident rooms not getting hot water. While Rotarooter is there they will temporarily fix this but it is reportedly an ongoing problem that needs more extensive work that has not been approved in the past to be completed. The LPM asked for the work order receipts be provided in addition to an estimate of work needed by no later than 02/25/21.

The RO received an incident report via phone from TM 02/22/21 that the facility has bed bugs in one room currently identified and an inspection is scheduled for later this week. This resident is reportedly noncompliant with allowing staff to clean their room and the room is cluttered with boxes. The resident does have a friend that visits and an inspection of that residents’ room as well as other area rooms will be conducted. RO to monitor. Facility to provide correction by 02/25/21.

RO received fire inspection via email 750pm 02/19/21 to include the annual fire alarm inspection and the fire sprinkler inspection are both past due as of September 2020. When the LPM asked the TM, she reported that the new owners are in the process of getting the inspections up to date and that the company had recently been to the facility to inspect both the alarm and the sprinkler system. The LPM asked that documentation of the inspections of both the alarm and the sprinkler be sent vis email to AshleyBoothe@dss.ca.gov by 02/25/21. LPM requested the last two quarterly fire drill logs to be provided by the end of day 02/24/21.