Facility Evaluation Report
On December 9, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. Upon arrival LPA observed the COVID-19 signage posted at the front entrance. LPA met with Caregiver, and Administrator, Maria Navarro joined shortly thereafter. LPA explained the purpose of the visit. Administrator was able to provide LPA screening log documentation for staff, visitors, and residents.
LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story facility with 3 resident bedrooms, 1 staff room, and 2 full bathrooms. LPA toured the facility living room and dining room and observed it to be free from tripping hazards. LPA toured the resident rooms and observed 1 shared room with beds 6ft apart from each other and 2 private rooms. LPA observed the full bathroom in the shared room and the other full bathroom in the hallway to be equipped with liquid soap, hand-washing signs, paper-towels and a trash can with a lid. Bathrooms were observed to be clean and in good repair. Extra linen was present and emergency bags were maintained in the facility closet.
LPA observed the COVID-19 signage posted throughout the facility. A comfortable temperate of 72 degrees F maintained and lighting is sufficient for comfort. During the visit, LPA observed 2 residents wearing masks. LPA toured the kitchen and observed medications and sharps stored appropriately and inaccessible to residents. Kitchen was equipped with liquid soap, paper towels, and hand washing signs. LPA observed 7 day non-perishable, however did not observe 2 day perishable. According to the Administrator, the facility staff will go grocery shopping today. LPA toured the garage and observed a washer and dryer in good repair. LPA observed 30-day PPE supply present. Toxins were observed to be locked and stored appropriately and inaccessible to residents.
According to the Administrator, staff are required to take COVID test prior to their shift.
Administrator to submit LIC308- Designation of Administrative Responsibility to CCL by 12/16/22.
Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 809D. Failure to correct the deficiencies may result in civil penalties.
Report is reviewed with Administrator and a copy is provided with appeal rights.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction