Facility Evaluation Report
On 11/15/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Administrator, Jason Johnson (AD) was not available during this inspection. LPA received verbal permission from AD to meet with Facility Manager, Elizabeth Ramos and Staff, Cindy Lopez. Upon entry to the facility, LPA observed staff to not be wearing facial coverings. Staff put on a mask once LPA entered the facility. Facility has one central entry and exit. A visitor log / temperature check was observed upon entry.
Facility tour conducted. LPA did not observe signs promoting hand-washing, social distancing, and cough/sneeze etiquette throughout the facility. LPA toured the facility kitchen. Food supply checked. LPA observed an adequate food supply. LPA observed an adequate supply of PPE and cleaning supplies.
Resident bedrooms checked. Beds observed to be at least 6 feet apart. Liquid soap and paper towels are available in the bathrooms. Hand-washing signs observed in resident bathrooms. LPA checked residents' medication and observed a 30 day supply. LPA observed the medication cabinet to be unlocked and accessible to persons other than employees. Resident and staff temperature checks are documented daily. Residents files were reviewed for updated emergency contact information.
LPA is requesting the following documents be submitted to the Fresno CCL office by 11/29/2022: 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.
A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted. A copy of this report and appeal rights were discussed and provided to FM whose signature on this form confirms receipt of this document.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction