Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Miller conducted a case management visit to cite a deficiency identified during a separate Required 1-Year Annual Visit for a separate facility. The facility is in close proximity to other facilities on a large cul-de-sac. LPA knocked on the front door to inquire if the facility was the one due for the annual inspection. LPA heard someone inside yell, "Come in." When LPA entered, she saw three residents sitting in the living room. Staff 1 (S1) entered the room then without a mask. LPA identifying herself and disclosed the purpose of the visit. LPA then asked if Heidi had a mask. LPA observed that S1 checked her pockets and did not pull out a mask. S1 stepped into the garage where PPE was stored to find a mask. LPA inquired what facility she was in and where she could find the correct facility to do her annual inspection.

A second caregiver (S2) entered the room without a mask holding a plate with debris on it. LPA introduced herself and asked where his mask was. Jubal took his mask from his pocket and explained that he had just finished eating.

A deficiency was cited Per Title 22, Division 6, Chapter 8 of the California Code of Regulations (see LIC809-D). An exit interview was conducted with caregiver to whom a copy of this report and the Licensee appeal Rights (LIC9058) were provided.