Facility Evaluation Report

On 01/30/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection - infection control. LPA introduced self, stated the purpose of visit and was granted entry to the facility by Administrator, Taima Lopez. Facility has one central entrance and exit.

Facility tour conducted. All pathways, entrances and exits were clear from obstructions. No fire clearance issues. LPA observed signs promoting hand-washing, social distancing, and cough/sneeze etiquette. Facility staff observed to be wearing facial coverings. LPA toured the facility kitchen. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. LPA observed a 30 day supply of PPE and cleaning supplies.

Bedrooms checked. Beds observed to be at least six feet apart or three feet apart with head to toe orientation. Liquid soap and paper towels are available in the bathrooms. Hand-washing signs observed in resident bathrooms. LPA checked residents' medication and observed a 30 day supply. Resident and staff temperature checks are documented daily. Resident's records reviewed for updated emergency contact information.

LPA is requesting the following documents be submitted to the Fresno CCL office by 02/13/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.

No deficiencies issued. Exit interview conducted A copy of this report was discussed and provided to Administrator, Taima Lopez, whose signature on this form confirms receipt of this document