Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai with Licensing Program Manager (LPM) Romeo Manzano and LPA Manuel Monter conducted an unannounced annual inspection focusing on infection control. LPAs and LPM met with Administrator Belinda Devano. There are 5 clients at the facility and 3 staff including Administrator were observed.

During visit, LPAs and LPM toured the facility to include the 1 living room, 1 recreation room, 5 resident rooms, 3 bathrooms, 1 staff room, kitchen, laundry area, dining area, garage and exterior. All fire exit routes are free and clear of obstruction. Toxins and sharp objects were secured. Medication stored in a locked cabinet.

Facility observed to have a designated central entry point to include a sign-in sheet and temperature check. Facility clean and disinfect twice daily and as often as needed. Bathrooms supplied with hygiene products and hand washing sign. Trash can with lid observed. LPAs and LPM observed a sufficient amount of Personal Protective Equipment (PPE). All staff are N95 fit tested. The following posters observed to include wash your hands, symptoms of COVID-19, importance of wearing a mask, and donning and doffing PPE.

During visit, the administrator will provide the following documents to updated facility file by 2/1/2023 and other required documents but not limited to:

No deficiencies were cited per California Code of Regulations, Title 22.This report was reviewed with Administrator Belinda Devano and a copy of the report was provided.