Senior Care Records.

Facility Evaluation Report

Pines By Cogir, the, Rocklin10/19/2021Licence 312700739

Capacity142
Census116
Date signed10/19/2021 10:41:15 AM
The inspector’s account

On, November 19, 2021, at 9am, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct a required 1 year inspection. LPA met with , General Manager John Robertson and explained purpose of inspection. Prior to initiating the inspection LPA completed COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; and completed a facility risk assessment. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: mask. Additionally, LPA was screened by the front desk personnel upon arrival.

John and LPA completed the inspection tool questionnaire with no issues or advisories to report.

Administrator certificate is valid. First aid kit fully stocked and ready for emergency use.. Common areas were clean and in good repair.LPA reviewed 6 staff files and 8 resident files. All Staff files had the required Criminal Records Clearance, Proper First Aid and CPR Certificates and are participating in training as required. All residents files had the required signatures for Consent to receive medical treatment, Emergency contact information, Physician's report and residents rights .

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