Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valero arrived unannounced to the facility to conduct an annual inspection. LPA confirmed with Licensee Pearl Ofodire that zero staff and residents have displayed any signs of COVID-19 in the last 10 days. LPA had temperature taken prior to being allowed entry into the facility.

The infection control domain tool was completed during today's visit. LPA Valerio discussed recent PINs, and reviewed facility COVID tracking procedures and documentation. The facility common areas were free from debris and clean. COVID-19 signs regarding social distancing, hand washing, infection control, and prevention strategies are placed throughout the facility. The common areas were clean and organized. During the visit, the facility was observed to be following all policies related to vaccinations, visitors, and the health and safety of the residents.

LPA Valerio and staff toured the physical plant inside and out to ensure compliance with Title 22 regulations. All emergency exits were clear from obstructions. LPA observed an emergency supply of food, water, and supplies. Medication cabinet, cleaning supplies, sharps were locked away and inaccessible to residents in care. Hot water was measured at 118.0*F. Room temperature was set to 72*F. All required furniture and furnishings were observed in the resident bedrooms and bathrooms. Resident rooms were clean and organized. Residents bathrooms had required hygiene items. Fire alarm, carbon monoxide detector, and fire extinguisher was fully charged and operational.

LPA requested reviewed documents to be sent via fax: Administrator Certificate, LIC 500, LIC 308, LIC 610, Surety Bond, and COVID-19 mitigation plan

Per California Code of Regulations, Title 22, Division 6, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was left at the facility with Licensee Pearl Ofordire.