Facility Evaluation Report
***THIS DOCUMENT WAS CREATED IN ERROR. THIS REPORT DOES NOT APPLY TO THIS FACILITY LOCATION***
On 08/12/2021, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit focused on infection control. LPA met with facility administrator Jayson Hernandez and explained purpose of today's visit.
LPA the toured facility's building and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring, containment strategies, environmental preparation and cleaning. PPE supply is observed as in place. Off site additional PPE is in storage for facility use. Medications, toxins and sharps are stored appropriately and inaccessible to clients. Facility ambient temperature is comfortable. Facility lighting is sufficient for residents and staff safety. Toilet and bathing facilities are equipped properly. Liquid soap is available. Clients have access to hand sanitizers as well. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 3 clients present and staff are present providing one on one supervision. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed as current. Staff first aid cards reviewed are current. Administrator certificate is current expiring 04/14/2022
The following updated forms are requested to be submitted to CCLD by 08/18/2021 :
• LIC 308 Designation of Administrative Responsibility
• LIC 400 Affidavit Regarding Client Cash Resources
No deficiencies cited during today's inspection.
Report is reviewed with Administrator Jayson Hernandez.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction