Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with Administrator Eugene Alangui and explained the purpose of the visit. A Dementia and Hospice Waiver is in place. The facility is a single story home licensed for 6 non-ambulatory residents. It consists of 4 resident bedrooms [2 shared & 2 private], 1 staff room, 2 bathrooms, dining room, kitchen, living room, family room, outdoor patio, and attached garage. The last fire/emergency drill was conducted on 9/15/2022. Administrator certificate expires 9/24/2022.

The interior and exterior physical plant was inspected. Smoke and carbon monoxide detectors were tested and operational.

COVID-19 Infection Control Practices and signs that promote hand washing, cough/sneeze etiquette, and physical distancing were observed in the entrance, common areas, hallways, bathrooms and client rooms. There is a screening station at the entrance of the facility to screen visitors.

If needed a designated COVID-19 isolation room will be in place.

A posted Emergency Disaster Plan was observed.

Centrally stored medications/30-day supply of medications were observed. Today's medications were unlocked in a plastic box container. Photo was taken.

The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food.

Sharps/knives were observed unlocked under the kitchen sink. Staff immediately locked the cabinet.

Facility has an adequate 30-day+ supply of Personal Protective Equipment (PPEs).

Resident (R1's) bed had full bed rails and is not presently enrolled in hospice. A citation was issued. Licensee was instructed to obtain a physician order for a half bed rail. A new order was obtained today.

Per California Code of Regulations, Title 22, deficiencies were observed. See LIC 809D. Exit interview was conducted with Administrator Eugene Alangui. A copy of the report and appeal rights were issued.