Facility Evaluation Report

Bordon Home IV, Union City08/12/2022Licence 019200318

Capacity6
Census4
Date signed08/12/2022 03:14:52 PM
The inspector’s account

On 8/12/2022 at 2:20PM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct an Infection Control Inspection. LPA met with Angelica Chavez, Caregiver and explained the purpose of the visit. Administrator, Shirley Borden, arrived at 2:35PM.

Upon entry, LPA's temperature was checked. LPA observed screening station and COVID-19 signs were posted on the patio door that facility uses as main entrance. LPA toured facility including but not limited to common areas, bathrooms, bedrooms, back yard, kitchen, and garage. LPA observed cough etiquette and physical distancing posted in the common areas. All hand washing stations were equipped with soap and paper towel. Hand washing posters were posted at hand washing stations. Hot water temperature in the shared clients’ bathroom was measured at 104.5 degrees Fahrenheit. Facility was doing laundry at the time of the inspection Fire extinguisher last serviced on 01/21/2021. There is a minimum of 7-day non-perishables and 2-day perishables foods.

During record review, LPA observed visitors log and temperature log for both clients and staff. LPA observed facility has a copy of the Infection Control Plan on file. LPA observed PPE, food, and paper supplies are sufficient.

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