‘ { ‘County oF Los ANGELES AAX & Public Health BARUARA FERRER, Ph.D, Mea. -MUNTU DAVIS, M.D.,NLPAL det. Sats Coury Heath Offer Fat Ove MEGAN MeCLAIRE, MS... Sscnd ara Ted Date sua ERETE-CLARK, RN, MSN ae Inkin Ct, alist asi i | Fax: (56209-5096, April 19, 2021 SENT VIA EMAIL Beverly Ito, Administrator Sakura Intermediate Care Facility 325 S. Boyle Avenue Los Angeles, CA 90033 RE: Transition Plan Dear Beverly Ito Los Angeles County Health Facilities Inspection Division (LAC HFID) and California Department of Public Health (CDPH) received the Transition Plan provided to us on March 29, 2021, pursuant to your facility's intent to cease operation. Upon review of the plan, it was determined that your Transition Plan does not contain the following information, under Health and Safety Code (HSC) 1336.2(g)(1)(A) through (F) prescribed as follows: © Number of residents who do not have a legal representative and do not have capacity to make decisions for themselves. * The reason for closure. In addition, the plan you provided is missing this additional requirement, which is applicable during a pandemic: «Given the danger that Coronavirus Disease 2019 (COVID-19) may pose to transferred residents, Transition Plans submitted during the COVID-19 pandemic must also include the measures that the facility will take to mitigate COVID-19 infection risk associated with resident transfers. The facility must also arrange appropriate future medical care and services for each resident, unless the resident or resident's representative has already made these arrangements After review and as noted above, the Transition Plan provided to us is rejected.Beverly Ito Page 2 April 19, 2021 The facility will be provided an opportunity to review LAC HFID and CDPH’s recommendations and re-submit an amended plan, as mandated by HSC 1336.2(g)(2). The facility may not issue a transfer notice to residents and/or their responsible parties until an acceptable Transition Plan is received and approved by LAC HFID and CDPH Ifyou have any questions, please call Ms. Zosima Carina Gaerlan, Program Manager Nurse at 626-312-1208. Sincerely, Suzette Leverett- Clark, Interim Chief Health Facilities Inspection Division ram Cru Zosima Carina Gaerlan, , BSN. Health Facilities Program Manager County of Los Angeles, Department of Public Health Health Facilities Inspection Division 3400 Aerojet Avenue, Suite 323 El Monte, CA 91731 (626) 312-1208 (626) 927-9276 Zosima.Gaerlan@CDPH.CA.GOV