Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a 10-day complaint inspection. LPA met with Tracy Osifo, Direct Support Personnel/Lead DSP, and explained purpose of inspection. LPA spoke to the Administrator by phone who indicated she was currently at an appointment and arrived at 4:10 pm. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, confirmed there are currently no positive Covid-19 diagnoses, and completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. The facility is a licensed level 4 home that is vendorized through Alta California Regional Center. LPA observed one client in the common areas at the start of the inspection and the remaining (3) clients to be in their rooms at the start of the inspection. LPA observed (3) DSP's and (1) nurse on shift during the inspection.

LPA and lead DSP toured the interior of the facility, including client bedrooms (4), bathrooms (3), laundry/garage, locked medication area, kitchen and common areas and observed the home to be clean, safe and in good repair and to not pose a health and safety risk or personal rights violation. LPA observed various Covid posters posted throughout the facility. Inside temperature was observed to be 70* F. Fire extinguisher last serviced 11/30/2021. LPA observed sufficient 2+day perishable/7+day non-perishable food. LPA observed locked sharps in the kitchen and toxins in the laundry room. Staff will assist clients with hand-washing and provides soap, sanitizer, and paper towels, when needed, due to (1) client who may ingest materials if accessible. Facility to post 1 2-steps to hand-washing in all bathrooms. LPA observed documentation of daily temperature checks for residents/staff in a binder. Staff/Client vaccination status was recently discussed with Administrator as well as visitor protocols currently in place per PIN 21-40 issued 8/27/2021. LPA observed signage with visitor protocols, effective 8/9/2021, posted near the front entrance.

LPA requested an updated copy of LIC308 during today's inspection by 12/27/2021. There were no deficiencies observed during today's inspection. Exit interview. Copy of report provided to Administrator who was informed that a subsequent annual inspection could be conducted on/around 2/7/2022.