Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo conducted an unannounced annual/infection control inspection. LPA met with Crizaldo Robles, care staff, and informed the purpose of visit. LPA called and spoke with Joseph Crisol, administrator. Administrator stated he can not come to the facility to meet LPA so he authorized Robles to sign and receive this report.

Facility has an approved LIC808 Mitigation Plan on file. Administrator has not submitted the new Infection Control Plan.

LPA toured the facility inside out with Robles. LPA inspected the common area, dining room, kitchen, hallways, bathrooms. shower room, side and backyard. LPA randomly selected 7 bedrooms for inspection. There's adequate food supplies of perishables good for 2 days and non-perishables good for 7 days.

LPA observed screening station by the front entrance with hand sanitizer, no touch temperature probe and Visitor's Log. Visitor's temperature and symptom checks are done at the entrance. Residents and staff are screened for COVID-19 symptoms, and temperature checked and recorded daily. Facility keeps record of proof of vaccination of residents and staff. Supplies of PPEs checked and observed adequate for 30 days, and antigen test kits are readily available. Trash bins were observed with foot pedal operated lids. Bathroom lavatories were observed with liquid soap and paper towels in dispensers. Staff were fit tested or N95 respirator last year, August 10, 2021. LPA verified, and administrator stated re-certification is scheduled for September 19, 2022.