Facility Evaluation Report

Pacaldo-yee, Hayward09/06/2022Licence 019201136

Capacity14
Census11
Date signed09/06/2022 02:19:47 PM
The inspector’s account

On 09/06/22 at 2PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an unannounced case management visit and explained the purpose of the visit with staff (S1) and administrator who authorized S1 to act on her behalf and sign the reports.

During the health and safety check, LPA observed a total of 3 staff wearing face masks and 11 residents at the facility. COVID screening was done by staff at the front entrance with no touch temperature probe, visitor's logs, hand sanitizers and additional face masks & gloves available on the screening station.

LPA toured facility with S1, including but not limited to bedrooms, kitchen, bathroom, and common areas. LPA observed resident (R1) relaxing in the visitation area with 2 other residents. LPA observed R1 did not have any swollen eyes or any marks on his face. Residents in care appear to be safe and there are no imminent health/safety concerns on today's date.

No deficiencies cited during the health and safety check. Exit interview conducted and a copy of this report provided.

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