Facility Evaluation Report

On 8/26/2022 at 3:00PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct an Infection Control Inspection. LPA met with Direct Care Staff, Ferdinand Ramirez. LPA spoke with Administrator, Vanessa Kruse and was informed that she cannot be present at the facility.

Upon entry, LPA's temperature was checked and asked to fill out visitor's log. LPA observed hand sanitizer at screening station. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common areas, garage, and outdoor areas. LPA observed cough etiquette, signs & symptoms, and physical distancing are posted in the common areas. All bathrooms were equipped with soap, paper towel, and garbage bin with lid. Hand washing posters were posted at sinks and bathrooms.

During record review, LPA observed visitors log and temperature log for staff. Client's temperature log was on the computer and staff was unable to access during inspection. LPA observed facility has a copy of Mitigation Plan on file. LPA observed staff were FIT tested in July 2022. LPA observed PPE, food supplies, and paper supplies are sufficient.

At 3:30PM, LPA observed unlocked cleaning supply cabinet under the kitchen sink. Staff locked up cleaning supply cabinet during inspection.

At 3:45PM, LPA observed lots of items along the side yard near the exit gate including old furniture, shower chair, pallets, boxes, and other items.

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

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