Facility Evaluation Report

On 1-31-23 at 1:13pm licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct an Annual inspection.. LPA was greeted by facility manager Stan Chesney and LPA explained the purpose of the visit. Administrator Chris Chesney was made aware of LPAs visit and purpose.

LPA inspected the physical plant with staff 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 facility with a current census of 4. Facility has 4 bedrooms and 2 bathrooms. 1 bedroom is designated for staff use. There is dining area off the kitchen and a formal living/TV area. LPA also conducted the infection control domain tool.

The facility submitted a LIC 808 mitigation plan, which was approved. 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 back yard. 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. Fire drills are conducted quarterly. Four staff charts were reviewed. All contents including first aid/CPR certifications, and fingerprint clearances are current. Facility liability insurance is updated.

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. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Facility has an emergency food and water kit.

Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Administrator.