Facility Evaluation Report

On 6/23/2022, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control . LPA met with Administrator Erin Alvidrez and stated the purpose of the visit. A tour of the facility was conducted. COVID-19 guidelines are in place.

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 cleaned with no obstruction or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Bathrooms have trash cans with lid. Hand washing posters were observed by the bathroom sink. Bedrooms are single occupant.

Food supply was checked and there appeared to be an adequate supply. Fire extinguisher in kitchen was

last serviced on 5/4/2022 and was fully charged. Cleaning and PPE supplies were checked. Staff records were reviewed for good health and infection control training. Residents wear masks when away from the community. Resident’s files have updated emergency contact information. Staff records were reviewed for good health.

LPA is requesting the following documents be submitted to the Fresno CCL office by 6/30/2022: 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 Administrator. Report signed on-site and printed copy provided.