Facility Evaluation Report
On January 24, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. LPA met with House Manager, Alfonso Tolentino and Administrator, Phil Surdel joined shortly thereafter. LPA Charitra explained the purpose of the visit. Upon arrival, LPA observed the COVID-19 signage posted at the front entrance. LPA was screened at entry point and House Manager was able to provide screening log documentation to staff, visitors and clients.
LPA toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA toured two story facility with the House Manager and observed living room and dining room to be clean and free from any tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. During the visit, there were no residents present. According to the House Manager, all six clients were at their day program.
LPA toured the client rooms and observed all 4 client rooms; two of which were shared rooms with beds 6ft apart of 3ft head-to-toe and two of the other rooms were single private rooms. LPA observed 3 full bathrooms to be equipped with liquid soap, paper towels, hand-washing signs, and a trash can with a fitted lid. Bathrooms were clean, odor-free, and in good repair. LPA observed first aid kit to be completed. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable. Sharps, medications, and toxins were observed to be locked and inaccessible to residents.
LPA toured the laundry room to have washer and dryer in good working condition. No chemicals were present in the room. LPA toured the garage and observed 30-day PPE supply and extra food present. Infection control practices are observed: entry procedures, daily monitoring log for staff, residents and visitors, 30-day PPE supply, face coverings for staff, containment strategies, staff training and policies.
No citations will be issued during this visit. Report is reviewed with Administrator and a copy is provided.
LPA requests the following forms to be submitted to CCLD by 2/3/23:
-LIC308 Desgination of Administrative Responsibility
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction