Facility Evaluation Report

Licensing Program Analyst (LPA) David Sicairos conducted an unannounced annual visit using the Infection Control Evaluation Tool. LPA met with Noelia Vidales and explained the reason for the visit. Program Manager Norman Machado arrived shortly thereafter. Physical Plant was toured, medications were reviewed, and food supply was inspected.

LPA and toured the home and inspected (5) bedrooms, (2) bathrooms, living room, family room, kitchen, dining room, office area, and attached 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 143.4F which is outside the required 105F - 120F degrees. Mr. Machado adjusted the water temperature during the visit. 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 and carbon monoxide detectors were observed throughout the facility and were tested and operable during the visit. 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. There is a working phone on the premises. Sharps are locked in a kitchen drawer and are inaccessible to clients. Cleaning supplies and disinfectants are locked in the garage 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 (4) client medications were reviewed. Medications are centrally stored in a locked cabinet in the kitchen. 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, the deficiency observed during the visit is documented on 809D. Exit interview held and a copy of the report along with appeal rights were provided.