Facility Evaluation Report

Licensing Program Analysts (LPAs) Kimberly Lyman and Jerome Haley conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPAs were greeted and granted entry into the facility by Caregiver Grace Dagdag and explained the reason for the visit. Administrator Melba Santos arrived during the visit. Administrator Santos has a current administrator certificate expiring on 06/30/2022.

At 2:00 PM, LPAs toured the facility with Administrator Santos. Facility has six clients present during today's visit. All client rooms had the required elements as well as restrooms stocked with soap/ sanitizer. LPAs observed the screening/ sanitizing station in the entrance of the facility. Facility takes client and staff temperatures daily and documents. LPAs observed the visitor screening area as well as documented temperatures for visitors. Facility has covid precaution postings as well as all required department postings. The facility mitigation plan has been completed and approved. LPAs observed adequate emergency food and water as well as the first aid kit. First aid kit contained all required items. LPAs observed locked medication drawer. LPAs observed unsecured scissors in an unlocked drawer. Fire extinguishers are mounted and charged. LPAs toured the outside grounds and observed the outside shaded visitation area. Exit gates are unlocked and self latching. Facility has a plan for covid testing clients and staff as needed as well as a plan for isolation. All staff and clients are vaccinated for Covid-19. Facility is conducting weekly surveillance testing on staff. LPAs reviewed all client files and all contained required documentation including updated emergency information.

LPA consulted with Administrator on the importance of maintaining an ample supply of N95 masks as well as serving appropriate food for clients in care. Additionally, LPA spoke with Administrator regarding posting the "Let Us No" poster in regulation size, 20" X 26."

Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.