Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a case management visit. LPA met with Martha Kautz, Program Assistant and Nancy Howard Day Respite Coordinator. The program is open on Mondays and Wednesdays from 10am to 2pm.

The day program operates out of a primary room within the Sebastopol Senior Center. There are 2 common bathrooms available for participant use and exterior space. Facility is currently open and is providing day program services. Facility has posters through the facility and have a centralized sign-in location. Facility screens all participants, visitors and staff upon arrival and sign them in. Facility has a designated area to enter the facility, facility consists of a large area that has been modified, additional tables and chairs were removed to ensure social distancing between staff and participants. Facility has sufficient personal protective equipment for staff and participants including face shields, gloves, hand sanitizer and masks. Liquid dispensers were observed in the entrance. All bathrooms and surfaces in the facility will be sanitized after each use or at least every 3 to 4 hours, participants have the option of eating at the on-site dinning area. Meals are provided pre-packaged meals by Meals on Wheels. Facility has requested that participants or their responsible parties check the temperature of participants each morning. Facility does not provide transportation services. If a participant is exhibiting symptoms, they are to stay home and notify the facility. Staff have received training on PPE and additional training will be provided. 100% of staff and participants are vaccinated. Facility has submitted and approved their Mitigation Plan on 7/20/21. LPA had technical difficulties pulling out the infection domain and contacted IT services and was informed that they need to work on issues when LPA is back to the office. LPA provided a printed copy to Day Respite Coordinator during this visit.

During today's visit LPA requested the following documents to be submitted to CCL by 11/19/21: Administrative Organization (LIC309) and Personnel Record (LIC501).

No deficiencies were cited during today's inspection.