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 Fe Punzalan and Designated Administrator, Mark Arvin Agustin.

During visit, LPA toured the facility to include the living room, kitchen, resident rooms, laundry room, bathrooms, and backyard.

No residents observed on-site. All fire exit routes were free and clear of obstruction. All staff present are fingerprint cleared and associated to the facility. All staff observed wearing a face mask.

Facility has a designated entry point for symptom screening and temperature check for all visitors and staff. Hand sanitizer made available at entry and throughout the facility. Bathrooms supplies with hygiene products, paper supplies, and hand washing sign. LPA observed facility's Personal Protective Equipment (PPE) supplies and trash can with lid. Resident's temperature and symptoms are monitored and documented daily. LPA observed resident's emergency contact information binder. Staff are trained on infection control and have been N95 fit tested. LPA reviewed facility's procedures to isolation, testing, reporting requirements, and visitation. The following posters observed to include symptoms of COVID, hand washing, face mask required, feeling sick, and cover your cough.

No deficiencies were cited per California Code of Regulations, Title 22.

This report was reviewed with Fe Punzalan and Mark Arvin Agustin and a copy of the report was provided.