Facility Evaluation Report

Licensing Program Analysts (LPA's) Ruth Wallace and Kesha Lewis arrived at this facility unannounced to conduct an Required 1 Year Annual Inspection Visit. LPA's introduced themselves to Administrator and explained the purpose of the visit. LPA's were screened for COVID-19 symptoms and temperature taken prior to being allowed entry into the facility.

LPA's and administrator toured inside and outside of physical plant to ensure the safety of the residents and compliance with Title 22 regulations. LPA's also conducted the infection control domain tool. The facility has a LIC 808 mitigation plan uploaded into FAS. LPA's observed the facility to have COVID-19 informational signs, social distancing signs, hand washing signs posted throughout the facility. The facility is able to designated and dedicated a COVID-19 bedroom, bathroom, and isolation area if needed.

LPA's observed the temperature inside the facility was measured at 76*F, which is within the required range of 68 degrees F and 85 degrees F. The hot water was measured at 105.8*F, which is within the regulatory range of 105 - 120 degrees F. Facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. LPA's observed the centrally stored medications area, cleaning supplies, and sharps to be locked and inaccessible to clients. Resident rooms was sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguishers are current and inspected on 08/4/2022.

LPA reviewed three (4) staff files. All staff is fingerprint cleared and associated to the facility and staff have current First Aid or CPR certifications on file. Facility is conducting initial and continuing training as required.

LPA reviewed two (2) resident facility files, COVID-19 Plan, and survey binder. All necessary documents were in place. LPA's observed the following posted on the facility wall: Facility license, sketch, See Something Say Something poster, Ombudsman poster, Theft and Loss Policy, Resident Bill of Rights, Rights of Resident/Family Councils.

LPA Wallace requested updated copies via email to LPA by August 15, LIC 308 - Designation of Administrator and, LIC 610E Emergency Disaster Plan

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was left at the facility.