Facility Evaluation Report

On 08/11/2022, Licensing Program Analyst (LPA) Walton arrived unannounced at the above facility to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and met with Administrator, Gabriel Torres.

LPA conducted a facility tour with Administrator. Facility appeared clean and odor free. Facility is cleaned and sanitized throughout the day. Resident bathrooms checked. Hand-washing signs observed by bathroom sinks. LPA observed signs promoting hand-washing, social distancing, and cough/sneeze etiquette throughout the facility. Bedrooms are single occupant.

LPA observed an adequate supply of PPE and cleaning supplies. Food supply was checked. Medications checked. Facility staff will reorder medication refills and staff will pick up medications each month. Resident records were reviewed. Staff records were reviewed for good health.

LPA is requesting the following documents be submitted to the Fresno CCL office by 08/25/2022: 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 (LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020), and Surety Bond.

No deficiencies issued during today's inspection. LPA conducted an exit interview with Administrator. A copy of this report was discussed and provided to Administrator, Gabriel Torres, whose signature on this form confirms receipt of this document.