Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an annual required – 1 yr. Infection Control inspection visit. LPA met with Jake Larkin, Adult Day Respite Program Mgr and Martha Kautz, Program Assistant. 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 building and have a centralized sign-in location. Facility screens all participants, visitors and staff upon arrival and sign them in. LPA was screened when arrived and results were documented on a checking log binder. The 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 at least three times per day, participants have the option of eating at the on-site dinning area. LPA observed that staff were wearing masks during this visit, 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.

During today's visit LPA requested the following documents to be submitted to CCL by 12/17/21: Administrative Organization (LIC309) and Personnel Record (LIC501).

No deficiencies were cited during today's inspection.