Facility Evaluation Report

Licensing Program Analyst (LPA) David Sicairos conducted an unannounced annual visit using the Infection Control Evaluation Tool. LPA met with Staff Paulette Thirsty and explained the reason for the visit. Administrator Kara Gulling was notified of the visit via phone call. Physical Plant was toured, medications were reviewed, and food supply was inspected.

LPA and toured the home and inspected (3) client bedrooms, (3) bathrooms, living room, kitchen, dining room, office area, and detached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The water temperature was tested in bathroom #1 in the hallway and measured at 105.5F which is within the required 105F - 120F degrees. Client bedrooms have the required furniture such as bed frames, dressers, lamps and chairs. Bedrooms also have sufficient closet space. Client beds have the required linen and the linen is in good condition. Sufficient hygiene supplies were observed for the clients in care. Smoke detectors were observed throughout the facility and were tested and operable during the visit. There is a carbon monoxide detector located in the kitchen of the home. There are multiple fire extinguishers located throughout the home which are fully charged. Kitchen appliances are clean and were operating at the time of the visit. Sharps are locked in a kitchen drawer and are inaccessible to clients. Cleaning supplies and disinfectants are locked under the sink and in separate cabinets and are inaccessible to the clients. First Aid kit was fully stocked with current manual.

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Staff were observed wearing masks and screening visitors at entry.

Sufficient supply of 2 days perishable & 7 days non-perishable foods were observed.

(3) out of the (3) client medications were reviewed. Medications are centrally stored in a locked closet in the living room. Medications are documented properly and given as prescribed.

Staff and Client files were not reviewed during today's visit.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.