Facility Evaluation Report

On 2/16/2023 at 12:15 PM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct an annual Infection Control Inspection. Upon arrival LPA was greeted by a Cargiver, Caregiver stated their name was "James". Administrator, Wardell Jackson arrived around 12:40 PM, LPA greeted them and explained the purpose of the visit.

During the Infection Control Inspection, LPA toured facility with including but not limited to front entrance, hand washing stations, bedrooms, common areas, kitchen, and backyard. Facility has a sufficient 2 day perishable and 7 day non-perishable food supply . Thermometer and hand sanitizer were observed. 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 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 extinguisher was observed serviced. LPA observed facility passages inside and out free of obstruction.

The following deficiency was observed during inspection:

-At approximately 12:30 PM LPA observed Staff 1( S1) was not associated to the facility nor did they have a criminal clearance. A civil penalty of $100 is being assessed today.

The following deficiency were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties

Exit interview conducted and a copy of this report provided along with Appeal rights.