Senior Care Records.

Facility Evaluation Report

Hazel Home, Santa Rosa04/22/2022Licence 496803290

Capacity6
Census5
Date signed04/22/2022 01:21:02 PM
The inspector’s account

License Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct a Required – 1 year Infection Control Inspection of the facility. LPA was welcomed by Administrator Debbie Miller for the visit. Facility has 5 clients at this time with 1 at a day program during visit. LPA had returned after Administrator called informing; she had returned to facility from an outing. LPA had temperature checked and logged.

LPA began tour of facility at 12:10 PM with Administrator Debbie Miller. The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Hot water temperature of faucets accessible to clients registered within 105 degrees and 120 degrees F. which is within regulation. There was nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days for current census. All medications were locked and inaccessible to clients' in care. All toxins were locked in the garage and inaccessible to clients. Emergency supplies are also kept in the garage. Laundry room contains enough linens for clients in care. All smoke alarms were functional and carbon Monoxide detectors were present. Required postings were observed. Sufficient lighting was present in common areas, hallways, and client rooms. Required furniture was also present in client rooms. Fire extinguished last charged November 11, 2021.

Facility has submitted a mitigation program plan that was approved, 5/18/2021. All staff and visitors check in and log temperatures and either have proof of vaccination on file or show proof of a negative COVID test within the last 72 hours. Posters have been placed at facility. The facility has a sufficient supply of personal protective equipment (PPE) stored in laundry room. Staff had all PPE training required; they are still working on getting N95 Fit Tested. All but 1 staff who has a religious exemption on file and clients have been fully vaccinated and received their COVID booster shots or are waiting for the six-month time date.

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