Facility Evaluation Report

Licensing Program Analyst (LPA) A. Canela arrived at this facility unannounced, to conduct an Annual Required 1 year inspection. This inspection will focus on the Infection Control procedures and practices of this facility. LPA met with house manager, Estella Constantino; Christina Noblejas was not available during the visit. There are currently 6 clients living in the facility and they receive services from North Bay Regional Center. LPA arrived at the facility and observed a cabinet at end of hall way by the front area with hand sanitizer and PPE supplies, staff took LPAs temperature but no Covid questions were asked. Facility was found to be at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be charged and inspected within the last 12 months. Toxins are stored and not accessible. Facility has submitted and received approval for a Covid Mitigation plan. Covid-19 Posters are in place at the entrance and throughout the facility. Facility has PPE supplies. Medications are secure and not accessible to clients. Facility has a 30-day supply of medication. Clients do not typically wear masks inside the facility but have them available. Staff were observed not wearing a mask during this visit, LPA requested all 3 staff to please put a mask on and reminded them to follow their Covid-19 mitigation plan and that masks must be worn by staff at all times they are inside this facility regardless of vaccination status. LPA reminded facility of requirement to maintain track of all visitors vaccination status.

LPA observed the facility is doing major bathroom remodeling in client C1's bedroom. Facility was reminded to inform CCL of any major repairs to this facility prior to construction. The bathroom was observed with flooring removed, wood appeared to be rotted, LPA was able to smell the water damaged wood, smell of mold and requested facility to provide information regarding work being done and date of completion. LPA also requested plan to ensure the safety of clients who occupy the bedroom. LPA also consulted in regards to facility ensuring all knifes are inaccessible.

The following deficiencies were observed (see LIC 809-D) and 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. Exit interview conducted and appeal of rights and this report will be emailed to facility due to printer problems.