Senior Care Records.

Facility Evaluation Report

Miracle Lane House, Fairfield11/03/2021Licence 486801750

Capacity6
Census4
Date signed07/14/2023 05:40:09 PM
The inspector’s account

An informal meeting was conducted today in the Rohnert Park Regional Office by virtual calling due to COVID-19 precautions. Present in the meeting were: Regional Manager Carla Nuti-Martinez, Licensing Program Manager Hope DeBenedetti, Licensing Program Analyst Karina Canela, North Bay Regional Center Senior Nurse Consultant Jeff Newton, Licensee Elpidio (Ed) Punzalan and Co-Administrator Virginia Punzalan. The purpose of the informal office meeting was to discuss areas of concerns on the implantation of the facility’s procedures regarding their COVID-19 Mitigation Plan Report for Epidemic Outbreaks specific to COVID-19.

Community Care Licensing (CCL) is requesting the licensee update the following sections in the facility's Mitigation Plans (LIC 808) which was discussed during today's meeting:

B. Staff – Protocol for staffing if: Directly exposed to COVID and/or are symptomatic.

Plan for where staff will quarantine to not rely on the facility

· Section 3: Quarantine/Isolation/Cohorting

A.Residents – RSP extra vacant home for people needing to be quarantined

Cohorting – Dedicated staff scheduled to work in COVID section with COVID positive residents

B. Staff – Positive, asymptomatic – only allowed to work in designated COVID-19 unit and seeking approval for asymptomatic staff to provide care for COVID positive and negative residents. Staffing plan to limit transmission. No crossing of staff between designated COVID-19 section and negative residents.

Facility contingency plan for staffing and source for additional staffing needs.

An addendum to the Licensee’s (4) facility’s COVID-19 Mitigation Plans with modifications/was requested during the informal meeting to be submitted to CCL by 11/30/2021

Failure to submit above documentation may result in the Department seeking further action. Failure to comply with updated Mitigation Plan may result in citations and civil penalties.

No deficiencies cited. This report was emailed to Licensee

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction