Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by caregiver and LPA explained the nature of the visit. Administrator arrived shortly after and met with LPA.

LPA Martinez began the tour of the facility, accompanied by Administrator. There are four clients in care and there are no active covid-19 cases in facility. LPA observed clients throughout the facility, all residents appeared to be clean and well taken care of. LPA observed required department postings, covid-19 precautionary postings in the facility. All restrooms observed to have ample supply of soap and appeared to be clean. All bedrooms observed to have all required components. LPA observed a check in station in the main entry of the facility. Facility is taking temperature daily and documenting the results. LPA observed the emergency disaster and evacuation plan. Facility has the back-up emergency food and water supply as well as PPE supplies in the attached garage. The facility has completed the LIC808 Mitigation Plan, LPA reviewed and approved the plan on today’s visit. LPA emailed the signed and approved plan to the Administrator for their records.

Based on the observation made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations.

This report was reviewed with the Administrator and a copy of this report was provided to the facility.