Senior Care Records.

Facility Evaluation Report

Lake Wildwood Manor, Penn Valley06/23/2022Licence 295002148

Capacity6
Census2
Date signed06/23/2022 03:20:17 PM
The inspector’s account

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 6/23/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Administrator, Mary V Love, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask.

LPA toured the facility to ensure the health and safety of the residents in care. Areas toured include but are not limited to: 4 bedrooms and 2 bathrooms for residents, common area, dining room, food supply, laundry room, garage, storage area, and outdoor area. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator completed the infection control domain.

No deficiencies are being cited. Exit interview conducted and copy of report left at the facility.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction