Facility Evaluation Report

Licensing Program Analyst (LPA), Chinwe Nwogene made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA was greeted and granted entry by caregiver Rolando Javier who was informed of the purpose of the visit. At the time of visit there was 3 staff and 3 residents present. The facility currently has zero positive or suspected Covid-19 cases.

During today's visit, LPA toured the facility inside and out with Rolando and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings posted throughout the facility. The facility has an adequate amount of hand hygiene supplies (soap, hand sanitizer and paper towels) in all restrooms. The facility has a plan in place to monitor residents regularly for any changes in condition, which includes daily temperature checks. The Facility will contact the resident's physician should there be any event of COVID-19 related illnesses. The facility has a designated infection control lead. The facility also cleans and disinfects the highly touched surfaces during each shift, and as needed. LPA observed PPE supplies. LPA did not observe any bodies of water within the premises. LPA was informed that no weapons or ammunition is maintained at the home. No annual fees due.

During LPA tour of the bedrooms, LPA observed client bedroom Three #3 and staff bedroom seven #7 were switched without floor plan being updated. LPA observed staff was using client bedroom three #3 and client using staff bedroom seven #7. LPA also observed client mattress in the staff bedroom on the floor without bedframe, drawer, nightstand and lamb. Rolando stated the bedframe was too high for the resident, so the bedframe was dismantled. LPA spoke to Administrator Marilyn Jimenez on the phone, who stated the bedrooms will be switched back and a new bedframe with other bedroom furniture will be bought by 10/21/2022.

Therefore, based on the observations made during today’s visit, One #1 deficiency was cited per Title 22, Division 6 of the California Code of Regulations. See LIC 809D. An exit interview was conducted, and this reported was provided along with and appeal rights to Rolando Javier.