Facility Evaluation Report

On 4/29/22 at 11:20 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry. Administrator was not available. Office Manager Adam Tauchen and Co-Administrator Gerald De Claro arrived a short time later.

LPA conducted tour with staff and did not observed any obstructions. No fire issues observed. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Hand washing posters were observed by the bathroom sinks. Bedrooms were checked and each resident has their own room. LPA checked residents’ medications. Cleaning and PPE supplies were checked. Resident files have updated emergency contact information.

The following deficiencies were observed:

1. Staff on duty, S1, was found to be fingerprint cleared, but not associated to the facility and has been working since 5/12/21.

2. First hall bathroom hot water tested at 100.4 degrees F and the second hall bathroom hot water tested at 102.5 degrees F.

3. Supply of nonperishable foods of minimum of one week was not maintained in the facility.

The following updated forms to be sent to CCL within 2 weeks: LIC500, LIC400, LIC402, LIC610D (new revision)