Senior Care Records.

Facility Evaluation Report

Montgomery Springs Manor, Hayward02/25/2023Licence 015601506

Capacity15
Census11
Date signed02/25/2023 11:00:33 AM
The inspector’s account

On 02/25/23 at 10AM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct infection control inspection. LPA met with administrator and explained the purpose of the visit. LPA observed 3 staff wearing face masks and 4 residents watching TV in the living room. The other residents were relaxing inside their bedrooms during visit.

LPA toured the facility including but not limited to the front entrance, screening station, hand washing stations, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizer were observed at the screening station. Cough/sneeze etiquette, social distancing signs were posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs maintained at a central location and easily accessible for staff. Comfortable temperature is maintained at 74 deg F. Facility has a mitigation plan in place and maintains records of routine screening for residents and staff. The infection control leader is the administrator.

Updated copies of the following documents were requested for facility file and are to be submitted to CCL on or before 02/27/23:

· LIC308- Designation of Facility Responsibility

· LIC610E- Emergency/Disaster Plan including infection control plans

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction