Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Wallace conducted Required 1 Year Annual inspection Visit. LPA Wallace explained the purpose of the visit to Administrator. LPA Wallace was screened for COVID-19 symptoms and temperature taken prior to being allowed entry into the facility.

LPA and administrator inspected physical plant. We toured inside and outside to ensure the safety of the residents and compliance with Title 22 regulations. LPA also conducted the infection control domain tool. The facility has a LIC 808 mitigation plan uploaded into FAS. LPA observed the facility to have COVID-19 informational signs, social distancing signs, hand washing signs posted throughout the facility. The facility is able to designated and dedicated a COVID-19 bedroom, bathroom, and isolation area if needed.

LPA observed the temperature inside the facility was measured at 74*F, which is within the required range of 68 degrees F and 85 degrees F. The hot water was measured at 106.7*F, which is within the regulatory range of 105 - 120 degrees F. Facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. LPA observed the centrally stored medications area, cleaning supplies, and sharps to be locked and inaccessible to clients. Resident rooms was sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher last serviced on 06/1/2022.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit.

An exit interview was held administrator and a copy of the report was left at the facility.