Senior Care Records.

Facility Evaluation Report

Corpuz Adult Residential Facility INC, Clovis05/25/2022Licence 107208859

Capacity6
Census6
Date signed05/25/2022 06:28:28 PM
The inspector’s account

On 05/25/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and met with Licensee Jimena Corpuz. LPA conducted a facility tour with Licensee Jimena Corpuz. All six clients present during tour.

Upon entry facility staffs was observed with facial mask. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to clients and visitors. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. LPA observed social distancing and cough etiquette postings in facility.

LPA checked clients’ locked medications. Food supply was checked and appeared to be an adequate supply. All clients’ room toured and observed to be adequately furnished and lit. LPA observed three shared clients’ bed to be at least 6 feet apart. All bathrooms observed trash bin with lid. LPA observed hand washing posting by all sinks. Cleaning supplies were stored and locked in cabinet in the laundry room.

The exterior tour was conducted. Outside free of obstruction and debris. LPA observed a 30-day PPE supplies. LPA observed fire extinguisher served date: 06/08/21. Staff records were reviewed for good health and infection control training. All clients’ records reviewed to have updated emergency contact information.

No deficiencies issued during this inspection.

Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 05/31/22. The following updated forms were requested: Lic 308, Lic 309, Lic 400, Lic 402, Lic 610D, Lic 808, Lic 9020, and control of property. LPA received copy of Administrator Certificate and Lic 500 during inspection.

Administrator was provided a copy of this report.

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