Facility Evaluation Report

On 8/4/22, 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 requested to meet with Administrator. LPA met with Yolanda De Avila, caregiver. Administrator Terrance Hardge was called and unable to attend meeting. Administrator authorized caregiver to received and sign report. LPA conducted a facility tour with caregiver. There are currently one client present during tour.

Upon entry facility staff 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 and observed a 30-day PPE supplies. Food supply was checked and appeared to be an adequate supply. LPA observed fire extinguisher served date: 7/24/22.

All clients’ room toured and observed to be adequately furnished and lit. LPA observed four bedrooms that are single occupant and two vacant bedrooms. All bathrooms observed trash bin with lid. LPA observed hand washing posting by all sinks. Cleaning supplies were stored and locked in facility office.

The exterior tour was conducted. Outside observed free of obstruction. At 08:43 a.m., LPA and caregiver observed gardening tools and paint cans stored in garage unlock . Staff’s record was reviewed for good health. All clients’ records reviewed to have updated emergency contact information.

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

Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 8/10/22. The following updated forms were requested: Lic 308, Lic 309, Lic 400, Lic 402, Lic 500, Lic 808, Lic 610D and Lic 9282. A copy of this report and appeal rights was provided to the caregiver and Administrator via email. Report signed on-site.