Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection and met with Lead staff Joyce; LPA observed another caregiver working, Grazelle.. The inspection is focused on the Infection Control procedures and practices of the facility.

The LPA was screened as required by staff, including LPA's temperature, all information was logged as required.

Administrator has submitted the Infection Control Plan as required. There is an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory. Per Administrator, fire extinguishers, two(2) of them, were purchased within the last few months from Costco; The Administrator will attach copy of receipt to extinguishers and ensure they are both serviced and tagged as required.-annually. There were three(3) residents in care at the facility during the inspection.

LPA observed the facility to be clean and orderly. The facility was at a comfortable temperature for the residents in care. There was a sufficient supply of food for residents in care. All exits were unobstructed. There was a sufficient supply of hygiene products, paper products, and cleaners. Sufficient supply of PPE. Medications are locked and inaccessible to residents in care. Toxins and cleaners are locked and inaccessible to residents in care.

LPA observed that the garage has been renovated/conversion to have staff room and 2nd bed set-up and used by staff.