Facility Evaluation Report

Licensing Program Analysts (LPAs) Luis Mora and Tony Vasallo conducted an unannounced annual visit using the Infection Control Evaluation Tool. LPA met with Administrator Mary Anne Nacua and explained the reason for the visit. Physical Plant was toured, clients files and medication records were reviewed, staffs files records reviewed and food supply was inspected.

LPAs and Administrator toured the home and inspected 3 client bedrooms, 2 bathrooms, kitchen, dining area, living room, staff room 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 clients located in the backyard. Passageways and exits are free of obstruction. The water temperature was tested in bathroom #1 and bathroom #2 and measured between 109F - 112F degrees which is within the required 105 - 120 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. There is a closet in the hallway with extra clean linen and supplies. Smoke detectors were observed in each room and throughout the facility. There is a carbon monoxide detector in the hallway of the home. There are fire extinguishers located in the kitchen and hallway which are fully charged. Kitchen appliances are clean and were operating at the time of the visit. Sharps are locked under the kitchen sink and are inaccessible to clients. Cleaning supplies and toxins are locked under the kitchen sink and are inaccessible to 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. Sufficient supply of 2 days perishable & 7 days non-perishable foods were observed in the kitchen and in a refrigerator in the garage. 5 out of 5 client files and medications were reviewed and no issues were found. 3 out of 3 staff files were reviewed and no issues were found. Medications are centrally stored in a locked kitchen cabinet. Medications are documented properly and given as prescribed.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Technical Advisory letter was provided due to not following 2 Covid-19 procedures. Exit interview held and a copy of the report was provided.