Facility Evaluation Report

On 1/23/2023 at 9:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct an Infection Control Inspection. LPA met with Administrator, Karen Sangco and explained the purpose of the visit.

Upon entry, LPA's temperature was checked and asked screening questions. LPA observed hand sanitizer at screening station and hand washing station located outside next to front door. LPA toured facility including but not limited to bedrooms, bathroom, kitchen, common areas, garage, and outdoor areas. LPA observed cough etiquette, physical distancing, and signs & symptoms posted in the common areas. All hand washing stations were equipped with soap, paper towel, and garbage with a lid. Hand washing posters were posted at bathrooms and sinks. Hot water was measured at 110.5 degrees F in the hallway bathroom.

During record review, LPA observed visitors log and temperature log for both staff and clients. LPA observed facility has a copy of Mitigation Plan on file. Staff were Fit tested and certificate cards were observed. LPA observed PPE, food, and paper supplies are sufficient.

LPA observed facility did not have a current copy of LIC610D completed.

The deficiency was observed (see LIC 809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiency may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided.