Facility Evaluation Report

On 5/11/2022, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Staff. Permission was received via phone from Administrator Rebecca Franklin to have Manager Joye Walker sign report.

Visitor log-in/temperature check, masks, and disinfection station were observed upon entry. Facility has one entrance/exit point. Hand washing and other various Covid-19 related signs were observed in the common areas. Facility staff observed with facial coverings.

Facility appeared cleaned with no obstruction or fire clearance issues. Fire extinguisher in kitchen was

last serviced on 1/17/2022 and was fully charged . Hand sanitizer was readily available to residents and visitors. Bathrooms have trash cans with lids. Hand washing posters were observed by the bathroom sink. Bedrooms were checked and beds are six feet apart or have head-to-toe orientation.

LPA checked residents’ locked medications and observed a 30-day supply. LPA observed a 7-day supply of

non-perishable foods and a 2-day supply of perishable foods. Cleaning and PPE supplies were checked. Staff records were reviewed for good health. Resident’s files have updated emergency contact information. No deficiencies were observed.

LPA is requesting the following documents be submitted to the Fresno CCL office by 3/18/2022: Current copy

of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC

309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel

Report (LIC500), Register of Facility Clients/Residents for LIC9020.

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