Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Miller conducted a case management visit to give a Technical Violation identified during a separate visit. LPA knocked on the front door and Staff 1 (S1) opened the door without a mask. LPA identifying herself and disclosed the purpose of the visit. LPA then asked if S1 had a mask. LPA observed that S1 quickly put on a mask.

During the visit, two visitors entered the facility without a mask and entered a resident room. LPA observed that visitors did not sign a visitor log, S1 did not screen them for COVID, and did not ask that they were a mask. Jushua "Justin" Mendoza, caregiver, was made aware of the visitors by the LPA. Caregiver requested the visitors to sign in and wear a mask.

A technical violation was cited Per Title 22, Division 6, Chapter 8 of the California Code of Regulations (see LIC9102). An exit interview was conducted with caregiver to whom a copy of this report and the Licensee appeal Rights (LIC9058) were provided.