Senior Care Records.

Facility Evaluation Report

Benjamin House, Santa Rosa07/11/2022Licence 490110162

Capacity6
Census5
Date signed07/11/2022 02:51:47 PM
The inspector’s account

Licensing Program Analyst (LPA) Cuadra conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and met with staff Rebecca Geisner. Licensee Joe Geisner was not able to come to the facility, but gave authorization for staff to sign the report.

LPA arrived at the facility and have their temperature checked and logged into a sign-in sheet. Once inside the facility, LPA observed that staff were wearing masks during this visit. LPA/staff conducted a walk-through of the facility and observed Covid-19 posters that included hand washing signs. Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer were observed in the common area of the facility. Facility bathroom are kept stocked with hand hygiene products. Commonly touched surfaces are disinfected at least twice a day. Facility is allowing indoor visitations and has antigen tests available to use for visitors. Facility is able to accommodate a single room for each client that needs to isolate and is able to serve meals and deliver medications. Facility staff have been trained on PPE protocols and three out of six has been N-95 fit tested. Staff and residents are being monitored daily and results are documented. Facility maintains a 30 day supply of medication. Facility has 100% vaccination rate and boosters for all staff and clients. Two out of five clients do attend to day program at least two to three days per week and two out of five clients do not attend to day program due to day program shutdown, but the facility provides activities. Clients do not typically wear a mask while in the facility, but they do wear masks when in the community. Facility has submitted their Covid Mitigation Plan and approved on 8/2/21. The facility submitted their infection control plan for CCL's review. Facility has more than a 30 day supply of Personal Protective Equipment (PPE) including masks, face shields and hand sanitizer. PPE supplies are located in an accessible place for staff.

Facility will provide updates of the following by 7/18/22: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), Emergency Disaster Plan (LIC610E), affidavit regarding client/resident cash resources (LIC400) and surety bond. No deficiencies cited during this inspection.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction