Facility Evaluation Report

Licensing Program Analyst (LPA) Williams arrived at the facility unannounced on 12/28/2021 to conduct a Required 1- Year Inspection utilizing the infection control domain. LPA met with Caregiver, Luisa David, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and contacted licensee and completed a facility risk assessment. LPA ensured he applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask.

There are no residents living in facility; and have never been any. Facility has no current plans to accept residents. Facility is being lived in by Administrator Liza David and her mother, Luisa David. LPA and staff completed the infection control domain and LPA went over current COVID infectious control protocols and health orders, in case the facility decides to accept residents at any point in the future.

Facility's new phone number is: (916) 745-3626.

No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report left at the facility.