Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA Gutierrez met with staff Rosemary Flores and discussed the purpose of the inspection. During the inspection LPA Gutierrez and staff Flores conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

This is a single-story house with six bedrooms, and three bathrooms, with one bedroom being occupied by staff. During the inspection LPA observed two staff and three residents in care while a fourth resident was on an outing with family. Residents were observed eating in the dining area and resting in the living room area. A 2-day supply of perishable and a 7-day supply of non-perishable food was observed during today’s visit. Upon record review LPA noted emergency care requirements were met. LPA observed the facility does not have a 30-day supply of PPE on hand; a Technical Advisory was given on this date. LPA observed hallways and walkways were free of obstruction.

LPA reviewed and confirmed facility policies and practices regarding resident screening; a Technical Advisory was given on this date, staff screening, visitation, COVID-19 surveillance testing, COVID-19 clearance testing, quarantine, isolation, cohorting, infection control training, PPE, staffing and staffing shortages.

Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. At 12:00 PM Administrator Arvin Bumanglag arrived. An exit interview was conducted, and a copy of this report was left at the facility.