Facility Evaluation Report

On 09/18/24 at 10:20 AM, Licensing Program Analysts (LPAs) L. Holmes and Patricia Manalo arrived unannounced to conduct an annual Infection Control Inspection. LPA was greeted by one staff upon entry and explained the purpose of the visit. Haidie Bautista, Administrator (ADM) was telephoned by the staff member and arrived about 5 minutes later.

Facility has a COVID-19 mitigation plan, ICP & EDP on file. LPAs reviewed the resident roster, staff roster and Emergency Disaster Plan. Facility continues to screen for COVID, has hand sanitizer, COVID-19 signage, and a visitor sign-in log. LPAs toured the facility including, but not limited to common areas, bathroom, kitchen, front and side pathways. LPAs observed mask, cough etiquette, social distancing and hand washing signs posted throughout. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap and covered garbage cans. ADM to add paper towels to shared bathroom. There is a surplus of PPE stored centrally located inside the facility that is accessible to all care staff. The facility's temperature was 68 degrees (F) and water in shared bathroom was 109.4. Fire extinguisher was observed full and expires 11/15/24. Smoke/Carbon Monoxide detectors were observed operational and first aid kit complete.

The following forms are to be updated and submitted to CCLD:

-LIC308 Designation of Administrative Responsibility (Reviewed)

-LIC610 Emergency Disaster Plan (Reviewed)

-An updated copy of Administrator Certificate(s) (Reviewed)