Facility Evaluation Report
On 10/30/2022, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a Required 1-yr Annual inspection. LPA met with direct care support, Erica Ocampos (Flores), and explained the purpose of the visit. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Facility's capacity is 6, LPA observed (3) clients present at the facility.
LPA and staff toured the interior of the facility to ensure health and safety of clients in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, and kitchen. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and staff followed the infection control domain guidelines and facility was found to be in compliance at this time. LPA observed the facility to have 2+ days of perishables and 7+ days of non-perishable food. LPA observed the Administrator Certificate #6009563735 to be up to date with the expiration date of 12/22/2023.
During this visit, LPA obtained a copy of the LIC 402.
LPA further requested a copy of Administrator Certificate, LIC 308, LIC 500, and LIC 808 to be submitted to LPA via fax or e-mail by Friday November 4, 2022.
No deficiencies are being cited as a result of today's inspection.
Exit interview conducted and copy of report left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction