Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's annual inspection focusing on infection control. LPA met with Administrator (ADM), Mark Sung.

During visit, LPA toured the facility to include the kitchen, living room, bedrooms, bathroom, garage, and backyard. Staff present observed wearing a face covering.

A no visitor sign at the main entrance was observed. ADM immediately removed the no visitor sign. Facility has a sign-in sheet for all visitors. LPA strongly recommended to screen visitors and staff for symptoms of COVID-19 prior to entering the facility. The main entrance was supplied with hand sanitizer and posters for COVID-19. Bathroom supplied with hygiene products. ADM was informed the use of air dryers and cloth towels was discouraged. ADM was informed to place paper towels and a hand washing sign in the bathroom. LPA did not observe at least a 30 day supply of Personal Protective Equipment (PPE). Staff are not trained on infection control and are not N95 fit-tested.

ADM states a resident at the facility tested positive for COVID-19 back in 2021. ADM states to have notified other parties besides Licensing. LPA did not observe the facility reported a COVID case to the Department. ADM states to send special incident reports (SIRs) to San Andreas Regional Center (SARC) but not to Licensing.

The following documents were requested by 01/06/2023 to include: LIC610D, LIC500, updated facility sketch, and the facility's infection control plan.

A deficiency was cited per California Code of Regulations, Title 22. Advisory notes provided. This report was reviewed with Mark Sung and a copy of the report was provided.