Facility Evaluation Report

On 7/12/2022, Licensing Program Analyst (LPA) K. Kaur arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and met with Staff. Administrator was contacted and would be assisting with the inspection.

All pathways, entrances and exits were clear from obstructions. LPA and staff began the tour at the facility kitchen. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Fire extinguisher in kitchen was last serviced on 10/04/2022 and was fully charged. Tour continued to the living room which has sufficient seating. LPA toured three resident rooms which were observed to be furnished with required furniture and adequate lighting. At 11:33 AM LPA observed the facility to have dust and cobwebs on walls, ceilings and door farms. LPA observed one resident’s bedroom to have debris on floor. At 12:38 PM LPA observed one resident room to be missing a window screen. Linen supply is kept in the laundry room. Cleaning supplies and chemicals are kept locked in the laundry room and garage. Medications are kept locked in the hallway closet. LPA observed sufficient seating under covered patio area. Backyard gate was self-latching and self-closing. Carbon monoxide and smoke alarm detectors installed and operational. LPA reviewed resident’s medication with the MARs and Centrally Stored List for any residents. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Frill Drill records were reviewed. Staff files were reviewed for good health. Staff files had First Aid training.

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

LPA is requesting the following documents be submitted to the Fresno CCL office by 7/19/2022: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan (LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.

An exit interview was conducted with Staff. Report signed on-site by staff and printed copy provided.