Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one year infection control annual visit. LPA was greeted, granted entry by staff and explained the reason for the visit. Facility staff contacted Administrator (AD) Elizabeth Maldonado via telephone and the AD responded at the end of the visit and spoke to LPA Haley. LPA did not observed the required "See Something Say Something" poster (PUB475) on the walls at entrance of the facility. LPA observed a screening station, with a screening log book, and temperature thermometer for screening clients and visitors. There were two clients present during the visit. At 11:45 am LPA began the tour of the facility. While walking up the stairs to the client bedrooms LPA observed bleach spots on the carpet and a crack in the left bottom corner of the upstairs hallway window. During the inspection of client rooms, LPA observed the clients have the necessary requirements: night stand, chair, lamp and storage space. At 11:50 am while in client room #1 LPA observed there are no curtains on the two bedroom windows. At 12:01 pm while in client room #3 LPA observed the blinds were broken. Bathrooms had soap, sanitizer, and paper towels. In client bathroom #1 LPA measured the water temperature at 105 degrees Fahrenheit. In client bathroom # 2 the water temperature was observed at 100.3 degrees Fahrenheit. At 12:02 LPA observed mold around the bathtub in bathroom #2. LPA toured the garage area of the facility. While in the garage LPA Haley observed a locked cabinet with client medication and a first aid kit with all the necessary requirements. At 12:05 whil in the garage LPA observed a hole in the ceiling. In the kitchen LPA observed a two day supply of perishable food items and seven days supply of nonperishable food items. The stove was clean and three of four burners were operational. LPA observed a dishwasher at 12:15 that was not operational. LPA observed knives and sharp objects in an locked tool box near the sink. LPA observed a missing drawer, and missing knobs to multiple cabinets in the kitchen. The facility has adequate PPE supply of gloves, surgical mask, and hand sanitizers. LPA observed extra linen, emergency food and water supply. In the backyard LPA observed tables and chairs for the clients in care. All smoke detectors were tested and are operational. Fire extinguisher's are mounted and charged. Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview conducted and a copy of the report was provided to the facility staff.