Facility Evaluation Report

Licensing Program Analyst (LPA) Walters arrived unannounced to conduct a Required 1- Year infection control visit, and was greeted by staff. The Administrator was not present during todays visit. This visit will focus on the infection control of this facility. The facility submitted a mitigation plan which was approved by Community Care Licensing on 06/03/2021.

When LPA arrived at the facility, staff checked LPA's temperature and signed LPA in using a sign in sheet. LPA is advising that the facility include screening questions into their sign in policy to monitor for COVID symptoms. Signs were posted at the entrance to inform visitors that a mask must be worn while inside the facility. All staff were wearing face mask. Bathrooms were supplied with hand washing supplies and paper products. Facility has a limited amount of Personal Protective Equipment. LPA is advising that the facility maintains at least a 30 day supply. Clients were sectioned off into separate activity rooms and engaged in activities. After LPA arrived, clients were taken to a community outing. Toxins were kept inaccessible to clients in care. The fire extinguisher was last serviced on 10/21/22. LPA observed that there were no carbon monoxide detectors in the facility. Administrator confirmed this by phone. Facility has hardwired alarms which are tested yearly. LPA learned that the current Administrator is Samika Simmons and that the Licensee has not yet reported the Change of Administrator to Community Care Licensing. LPA is requesting that the facility submits the following forms to Community Care Licensing by 3/25/22, attention LPA Walters: LIC 215, LIC500, LIC308, LIC501 and statement from board of resolution. A technical assistance citation was issued today for not reporting change of Administrator, as required by regulation 85061(b), and for not maintaining a 30 day supply of PPE. Exit interview conducted with staff.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. This report was read and discussed with Esther Penaflor Appeal rights were provided.