Facility Evaluation Report
Licensing Program Analyst (LPA) Janira Arreola, made an unannounced visit on 10/24/2022 at 01:15 p.m. in order to conduct an annual visit with a focus on infection control. LPA met with staff Jennifer Powell, who was informed of the purpose of the visit. At the time of the visit there were (2) staff and (2) residents present.
LPA proceed to conduct a walk through of the facility's interior and exterior. LPA observed there was a central entry point where screenings are conducted for facility visits. LPA observed COVID-19 postings throughout the facility. The facility has a 30-day supply of PPE equipment that is readily accessible for residents and staff. The facility has a designated visitation area in the facility. LPA observed the resident bedrooms that would be used as isolation rooms. The resident bathrooms were observed to be clean and have the appropriate hand hygiene supplies such as hand sanitizer, soap, running water and paper towels.
The facility has a cleaning plan in place to disinfect and clean the high touch surfaces of the facility and the isolation rooms. The staff have leave in case of contact or testing positive for COVID-19. The staff have been trained on how to properly don and doff the PPE equipment, and there is a plan of care in place to attend to those residents that would be in the isolation rooms. LPA was informed that the staff have not yet been FIT tested for an N95 respiratory. LPA will document technical advisory note for this.
LPA reviewed the LIC500 and reviewed the Guardian roster to ensure all staff had been cleared. Staff #1 (S1) had 2 profiles open on Guardian which stated "in process" and "fingerprints not taken". LPA reviewed Guardian and found that all inquires on the staff's background were in process. The LPA will document an 809-D page for the deficiency and document plan of correction. LIC421BG will be documented with civil penalty amount of $500.
An exit interview was conducted where this report, LIC809-D page, and appeal rights were reviewed and provided to staff Jennifer Powell.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction