Facility Evaluation Report
On 06/28/2022, Licensing Program Analysts Mandeep Kaur and Christine Dolores (LPAs) conducted an unannounced annual inspection. LPAs met with facility Staff Rosa Cervantes. After 10 minutes, Administrator John Tanaka and Program Manager Elizabeth Fox joined the LPAs.
Upon arrival, LPAs observed the "No Visitor" sign posted on the front door. LPAs advised of the visitor guidelines and staff immediately removed the No visitor sign.
Staff did not take LPAs' temperature nor screened LPAs for the COVID symptoms. 30 days supply of PPE was observed. Social distancing, symptoms and warning signs of COVID, and cough etiquette signs observed to be posted in all public areas. LPAs toured the facility, including living room, kitchen, dining room, laundry room, 3 resident bedrooms, 1 staff room, 2 bathrooms, and back yard. All emergency exits noted to be clear of obstruction. LPAs observed paper supplies and hygiene supplies in the bathrooms. LPAs advised to place the hand washing signs in the bathrooms and during visit, administrator placed the hand washing signs in the bathrooms. At least 2 days' supply of perishable food and at least 1 week's supply of non-perishable food was observed on the premises. All cleaning supplies and chemicals noted to be in locked cabinets and closets.
AT 2:22PM, LPAs observed the 3 unsecured knives on the kitchen counter. Staff immediately secured the 3 knives. LPAs observed the floor to contain dirt and the dark spots. Staff stated that they mop the floor every two weeks. LPAs observed spider webs along the wall of the living room. LPAs observed the residents' dirty laundry piled on the floor of the garage. Staff stated that laundry gets done once a week by the residents.
Administrator confirmed that all staff and residents have been vaccinated and Boosted.
Deficiencies were cited per California Code of regulations Title 22. Advisory notes provided
This report was reviewed with Administrator John Tanaka and Program Manager Elizabeth Fox . A copy of the signed report and appeal rights was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction