Senior Care Records.

Facility Evaluation Report

Golden State Care Home, INC, Antioch09/07/2023Licence 079201210

Capacity4
Census0
Date signed09/07/2023 03:44:16 PM
The inspector’s account

On 09/07/23 at 2:50PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed no clients at the facility. ADM stated they are working with Regional Center of the East Bay (RCEB) in getting level 4I clients at the facility.

LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, clients and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizer were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 115 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged. LPA reviewed 1 staff file. LPA also conducted 1 staff interview during visit.

Updated copies of the following documents were collected for facility file:

 LIC308- Designation of Facility Responsibility

 LIC610D- Emergency/Disaster Plan including infection control plans

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided .

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