Facility Evaluation Report

On 12/02/2021 at 10:50, Licensing Program Analyst (LPA) C. Fowler arrived unannounced to conduct Infection Control Inspection. LPA met with Maria Serondo, Caregiver. Administrator, Ronan Rances arrived at approxmitaly 11:25am and LPA explained the purpose of the visit.

During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable 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. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff.

During inspection LPA observed a small bedroom attached to the garage which is not on the facility sketch.

LPA also observed building materials located in the backyard.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations,

Exit interview conducted and a copy of this report and appeals right discussed and provided.