Facility Evaluation Report

Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct an Annual Required - 1 Year inspection and met with Dinah Belandres, co-administrator, who wore a mask during the inspection. The annual inspection is focused on the Infection Control procedures and practices of this Adult Residential Facility.

LPA conducted a walk-through of the facility with co-administrator and observed COVID-19 precaution postings. A sign-in area was observed at front entrance of facility which had hand sanitizer and a sign-in sheet for visitors. The facility has designated visitation areas, provides virtual visits and phone calls for family to stay in contact with clients. Co-administrator stated staff and client's temperatures are taken once a day.

LPA observed 4 clients in care. The facility has a supply of PPE including gloves, face shields/goggles, N-95 respirators, surgical masks and disposable gowns. The facility has submitted a COVID-19 Mitigation Plan Report on Epidemic Outbreaks specific to COVID-19 which was reviewed by the California Department of Social Services, Community Care Licensing (CCL).

LPA discussed the following with co-Administrator Dinah Belandres regarding CCL requirements:

· Screening station - screen all visitors for COVID-19 symptoms (including temperature check) & logging it.

· Updated requirements for visitation listed in State Public Health Officer Order dated 12/31/2021 and CCL Provider Information Notice (PIN) 22-04-ASC.

· COVID-19 staff training: infection prevention, symptoms, and transmission.

· N-95 respirator Fit testing (Cal/OSHA requirement) for staff.

· Facility to ensure clients have liquid hand soap, toilet paper, and paper towels accessible in all bathrooms

· Keeping a log of temperatures taken for clients and staff.

9 technical assistance advisory notes were issued today related to COVID-19 precautions and requirements.

Exit interview conducted with co-Administrator, whose signature on this document confirms receipt. No deficiencies cited during this inspection