Facility Evaluation Report

On 8/2/22, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an

Annual Inspection-Infection Control. LPA met with Licensee Ceiara Sparks and stated the purpose of the visit.

Visitor log-in/temperature check, masks, and disinfection station were observed upon entry. Facility has one

entrance/exit point. Facility staff observed with facial coverings. Facility appeared clean with no obstruction or

fire clearance issues. Hand sanitizer was readily available to residents and visitors. Hand washing and other

various Covid-19 related signs were observed in the common areas.

Sharp items and cleaning supplies were secured in a locked cabinet under the sink. Medications were secured in a locked chest of drawers in the living room. LPA observed a 7-day supply of non-perishable foods

and a 2-day supply of perishable foods. Fire extinguisher in the Kitchen was last serviced on 4/19/2022 and

was fully charged. Cleaning and PPE supplies were locked in the laundry area. Bathrooms have trash cans

with lids. Hand washing posters were observed in the bathrooms by the sink.

Staff records were reviewed for good health, infection control training. Residents wear masks when away from the community. Resident’s files have updated emergency contact information.

LPA is requesting the following documents be submitted to the Fresno CCL office by 8/9/2022: 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 (LIC610E),

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

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