Senior Care Records.

Facility Evaluation Report

SVS Antioch Adult Day Program, Antioch11/03/2022Licence 079200833

Capacity75
Census18
Date signed11/03/2022 11:02:10 AM
The inspector’s account

On 11/3/2022 at 9:50AM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct an Infection Control Inspection. LPA met with Nikia Smith, Program Director, 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, bathrooms, kitchen and back sitting area. All hand washing stations were equipped with soap, and paper towel, and hand washing poster. Fire extinguishers last serviced 4/2022. LPA was not able to measure hot water temperature in the shared clients’ bathroom due to water is automatic and shuts off.

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 11/10/2022 :

Exit interview conduct and a copy of this report provided.

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