Facility Evaluation Report

On 09/18/24 attempted visit. On 09/30/24 around 09:30 AM, Licensing Program Analysts (LPA) L. Holmes and P. Manalo arrived unannounced to conduct a required annual Infection Control Inspection. LPA was greeted by the Care Staff Pablo De Leon.

LPA obtained a resident roster and staff roster. LPA observed hand sanitizer, masks, and COVID-19 signage. LPA toured the facility including, but not limited to common areas, bathrooms, kitchen, garage, and backyard. LPA observed mask, cough etiquette, social distancing and hand washing signs posted throughout. ADM to post 20 seconds to hand washing sign in the kitchen. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap and garbage cans. Hot water temperature in the shared upstairs residents' bathroom was measured at 106.1 degrees Fahrenheit (F). Fire extinguisher was observed full and last inspected on 06/06/2022 & 06/06/2023. Smoke/Carbon Monoxide detectors were observed operational.

The following forms are to be updated and submitted to CCLD:

-LIC308 Designation of Administrative Responsibility

-An updated copy of Administrator Certificate(s)