Facility Evaluation Report
Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) DENNIS DONNELLEY..Upon arrival, ADM took LPA body temperature, and checked LPA in the visitor log book.
LPA toured the facility inside out with ADM. COVID posters were observed at main entrance and in the facility. Screening station with masks, hand sanitizer, glove, thermometer and visitor log book was observed at the main entrance. Living room, family room, kitchen, dinning room and two restrooms were inspected. All trash cans were observed with covers. Paper towels were observed with holders. No posters of washing hands for 20 seconds were observed by the sinks of kitchen and restrooms. ADM stated the facility will put the posters of washing hands for 20 seconds by the sinks in 3 days. Cloth towels were observed in kitchen. ADM stated ADM will put more paper towels with holders in kitchen. Three resident bedrooms, and laundry room were inspected. One staff live-in room was observed in facility. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. ADM stated ADM is planing to relocate the medication closet, knives closet, and cleaning product closet. Room temperature was at 79 degree F, and hot water temperature was at 106 degree F in facility. 4 residents and 1 staff were observed in facility.
Fire extinguisher was serviced on 08/14/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.
ADM stated all the residents and staff are fully vaccinated and done with boosters. The facility already submitted LIC9282, Infection Control Plan to CCL office. No deficiency or citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction