Facility Evaluation Report

Licensing Program Analyst (LPA) Walters arrived unannounced to conduct a REQUIRED 1 Year Annual Inspection. LPA was greeted by Administrator, Fabricio Santos. This visit is focused on the infection control. The facility submitted an infection control mitigation plan to Community Care Licensing, which was approved on 09/30/21. At the time of inspection, there was one staff providing care and supervision three clients in care.

LPA began tour with Administrator at approximately 1:05 PM. The facility was clean and a comfortable temperature. There were no exits that were obstructed. Signs were posted throughout the facility to promote social distancing and hand washing. LPA observed a 30 day supply of medication and incontinence products.

LPA conducted a record review of staff and resident records. LPA learned through record review that all staff have been vaccinated, and have been trained on infection control and the use of Personal Protective Equipment. Per Administrator all staff have been fit tested for N-95 mask. Client's vaccine cards are stored in their individual files. The carbon monoxide and smoke detectors were tested and they appeared to be in working order. 2 of 2 Fire extinguisher was last serviced on 06/17/2020.

Having fire extinguisher inspected yearly

Creating a sign in area with a screening list and temperature gun.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiencies and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Licensee Eileen Saddi whose signature below confirms receipt of this report.