Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Ernie Manaois. HM took LPA body temperature, asked the infection control questionnaires, and checked LPA in the visitor log book. COVID posters were observed at main entrance and in the facility. Screening station with masks, hand sanitizer, thermometer, and visitor log book was observed. One staff was observed in facility.

LPA toured the facility inside out with HM. Family room, dinning room, kitchen, office, and 3 restrooms were inspected. Paper towels were observed with holders. Not all trash cans were with covers. HM stated the facility will change all the trash cans in today. Washing hands posters by the sinks were observed. There are 4 resident single rooms and 3 resident shared rooms in facility. There are 2 staff live in rooms in facility. The beds in shared were observed 6 feet apart. LPA observed 8 residents in facility. Room temperature was at 72 degree F, and hot water temperature was at 108 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Knives closet, medication closet, and cleaning product closet were observed locked. The facility is equipped with smoke and carbon monoxide detectors. HM tested the smoker detectors, and they were working fine.

PPE supplies were observed sufficient. Front yard and backyard were inspected. There was no obstruction to block the walkways. HM stated all the residents and staff are fully vaccinated and done with boosters. The facility already submitted the Infection Control Plan to LPA/

No citation were noted today. Exit interview was conducted with HM. A copy of this report was provided to HM.