Senior Care Records.

Facility Evaluation Report

Evelyn Manor, San Leandro12/15/2022Licence 019200658

Capacity4
Census4
Date signed12/15/2022 10:07:56 AM
The inspector’s account

On 12/15/2022 at 8:55 AM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct an annual Infection Control Inspection. LPA met with Administrator, Irene Monteclar and explained the purpose of the visit. Facility is currently in outbreak as of 12/13/2022.

During the Infection Control Inspection, LPA toured facility with Irene including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen, and backyard. Facility has a sufficient two day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents, and visitors. A sign-in policy, Covid questionnaires, thermometer and hand sanitizer were observed at screening station. Hand washing posters were observed. Common touched surfaces are disinfected at least once daily.

Bathrooms are equipped with liquid soap, paper towel and trash bins with touchless lids. Facility staff were observed to be wearing proper PPE. Facility has a 30 day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff . Smoke and carbon monoxide detectors were observed and maintained. First Aid kit was complete. Fire extinguishers was observed serviced. LPA observed facility passages inside and out free of obstruction.

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