Facility Evaluation Report

Licensing Program Analysts (LPA) Hansen conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and was welcomed by Licensee Lily Alcones. Administrator Arthur Alcones arrived shortly after. There were 6 residents present at the facility with 2 on hospice. LPA had computer issues and had to leave without obtaining signature. LPA emailed documents for signature of visit.

LPA toured the facility at 1:10 PM with Licensee Lily Alcones. During tour on 7/19/2022 facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be last charged on 9/15/2021 at the time of the visit. Smoke Detectors & Carbon monoxide detectors were found to be operational during the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility staff understands that food stored in the kitchen refrigerator must be properly stored as per regulations. Hot water temperature measured 105.6 degrees F and 106.7 degrees F within acceptable regulations of 105 to 120 degrees F in 2 of 2 resident’s bathroom faucets. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Toxins are secured and inaccessible in locked garage cabinets.

During the inspection, LPA observed individual (I1) to be present and providing care at the facility. LPA verified in the facility Personal Report/Roster in Guardian that I1 was not associated to Spring Creek Lodge. Administrator stated the required paperwork to associate I1 to the facility had been filled out and believed was associated. LPA contacted the Rohnert Park Regional Office and confirmed I1 is not associated to Spring Creek Lodge but is background cleared and associated to their other facility Sleepy Hollow Assisted Living. Administrator stated I1 has been working at Spring Creek Lodge for 4 months. LPA confirmed with the Rohnert Park Regional Office that I1 has fingerprint clearance but is not associated as required.