Facility Evaluation Report

Licensing Program Analyst (LPA) Joanne Roadilla conducted a Technical Assistance (TA) tele-visit today via Teams Meeting with Program Clinical Consultant (PCC) Nurse Helen Shi, RN and Licensing Program Manager (LPM) Romeo Manzano. The purpose of the tele-visit was to provide guidelines for Infection Control and Prevention. Present during the tele-visit was administrator (ADM) Melissa Ramos and two staff.

The day program facility was toured virtually with ADM. Per ADM, there are 6 staff and no clients at the facility, all programs are currently being done virtually.

Based on facility tour and interview with ADM, the following recommendations were provided:

1. Place hand-washing sign next to the hand-washing station outside of the facility.

2. Designate a staff who will conduct symptom checking of other staff.

3. Post sign on sick room door to wear full PPE before entering the sick room.

4. Post proper PPE donning/doffing instructions on sick room door.

5. Conduct regular staff training for proper PPE donning/doffing.

6. Ensure all staff have completed N95 fit testing per Cal/OSHA.

Facility was provided with some reference materials for PPE use and PIN 21-10-ASC Fit Testing Resources.

No deficiencies issued per Title 22 of the California Code of Regulations. A copy of the report was provided to Melissa Ramos via e-mail for signature.