Facility Evaluation Report

On 11/22/2021, Licensing Program Analyst (LPA) M. Yang arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA was met by caregiver Ansar. Caregiver called Administrator. Administrator state unable to attend meeting and authorized caregiver to sign and received report. Upon entry staff was observed not wearing facial covering. Visitor log in/temperature check was not observed upon entry.

LPA conduct tour with caregiver. Two clients were present during the tour. Facility has one entrance/exit point. Facility is currently renovating. Social distancing is maintained in the common and dining areas. LPA observed social distancing postings. Food supply was checked and there appeared to be an adequate supply. LPA checked residents’ locked medications. Chemicals are secure and locked under kitchen sink and cabinet in laundry room. LPA observed fire extinguishers with a service date of: 07/20/20. Last fire drill 07/06/21. LPA did not observe a 30-day PPE supplies. Trash bin in bathrooms was observed with no lid. LPA observed hand washing posting by bathroom sinks. LPA toured all bedrooms. All 4 bedrooms are single occupant and observed to be adequately furnished and lit. The exterior tour was conducted. Side gate was self-closing and self-latching. Staff records were reviewed for good health and infection control training. All residents have updated emergency contact information.

A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6.

Exit interview was conducted. Please submit the following forms/information to Fresno CCL by: 12/3/21. Requested forms/ information: LIC 308, LIC 400, LIC 402, LIC 500, LIC 610D, LIC 9020, and LIC 808. Due to COVID-19 precautionary measures, a copy of this report and appeal rights will be provided via email. Report signed on-site