Senior Care Records.

Facility Evaluation Report

Community Integrated Support Services, Antioch05/23/2022Licence 079200012

Capacity30
Census29
Date signed05/23/2022 02:51:59 PM
The inspector’s account

On 5/23/2022 at 2:00PM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct an Infection Control Inspection. LPA met with Jechane Reyes, Director of Operations , and explained the purpose of the visit.

Upon entry, LPA's temperature was checked. LPA observed screening station that contained hand sanitizer and sign-in log. LPA toured facility including but not limited to common areas and bathrooms. All hand washing stations were equipped with soap, and paper towel, and hand washing poster. Hot water temperature in the shared clients’ bathroom was measured at 105.1 degrees Fahrenheit. There were not any clients present during visit.

During record review, LPA observed facility has a copy of Mitigation Plan on file. LPA observed PPE and paper supplies are sufficient.

The following forms are to be updated and submitted to CCLD by 5/30/2022 :

-LIC308 Designation of Administrative Responsibility

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