Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a case management visit. LPA Valerio was met with facility staff Edna Villanueva. LPA was screened for COVID-19 symptoms and temperature taken prior to being allowed entry. Facility staff confirmed residents and staff have not had any signs or symptoms of COVID-19 in the last 10 days.

LPA Valerio toured the facility to ensure compliance with Title 22 regulations. Facility was clean and items were organized. All emergency exits were clear of obstructions. Facility had a 30-day supply of PPE. LPA interacted with residents and staff during the visit. Resident and staff engaged in facility activities and ate lunch during visit.

LPA Valerio reviewed 4 staff files. Staff 3 did not have an updated First Aid/CPR certification on file. Staff 3's First Aid/CPR certification expired 10/2021. Staff 4 did not have a health screening report or TB Test clearance on file.

Based on observations and record review, deficiencies are being cited during today's visit. See LIC 809-D. Appeal rights provided. Failure to correct deficiencies may result in civil penalties. Exit interview held with facility staff, and report was left for Administrator Lionel Nunez.