Facility Evaluation Report

On 8/9/2022 at 01:20 PM Licensing Program Analyst (LPA) L. Ibo arrived unannounced to conduct an infection control annual required inspection. LPA met with S2, LPA called Administrator Ellen Russell and informed her the purpose of the visit. Facility has census of 4.

LPA toured the facility inside and out including but not limited to common areas, resident rooms, bathrooms, kitchen and backyard. No bodies of water. Facility has enough supplies of PPEs, paper supplies and hygiene supplies. Medications are centrally stored in a locked area that is inaccessible to residents and refilled every at least 30 days.

Facility has enough 2-day perishable food and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE (mask). Facility has a mitigation plan and infection control plan. Facility maintains record of routine screening for residents and staff.

· At 1:31pm LPA observed over the counter medications are accessible to residents in care. Corrected during the visit, staff locked medication.

· LPA requested a copy of an updated Covid19 training for all staff. Staff last Covid19 training was 2021. (Technical assistance provided)

Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due dates, and any repeat violations within 12-month period may result in civil penalties.

Deficiencies and plan and proof of corrections were discussed with Ellen Rusell. Exit interview conducted and appeal rights copy of this report provided.