Facility Evaluation Report

On 8-8-22 at 1:28pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Medina Carcido and explained the purpose of the visit.

LPA Bilger inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. Facility is a 6 bed adult residential facility with a current census of 6. Facility has 3 bedrooms and 2 bathrooms for resident use. A separate office/living room is off the entry way. There is a separate laundry room with access which leads to garage access. Dining area is off the kitchen area. LPA observed laundry detergent accessible to clients in care in laundry room and garage. Additionally, LPA observed paint in cans in the garage accessible to clients. LPA also conducted the infection control domain tool.

The facility has an approved COVID Mitigation plan in place. The facility has central entry point and has implemented screening and sign in procedures at the front door area. The facility conducts routine symptom screening for employees, residents, and visitors. LPA observed the facility to have hand washing, COVID - 19 informational, and social distancing signs posted throughout the facility, on the front door, and backyard. The facility has a designated infection control lead. The facility is able to designate and dedicated a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. Seven staffing charts were reviewed. 3 of 7 charts contained expired First aid/CPR certifications.

Water temperature reads between 105*F and 120*F in the bathroom and room temperature reads 72*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. No obstructions to fire exits noted. {Cont. on 809C}