Facility Evaluation Report

On 2/23/2023, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. LPA met with Administrator Gladys Hernandez and stated the purpose of the visit. LPA requested documents be submitted to update Administrator on file.

Visitor log-in/temperature check, masks, and disinfection station were observed upon entry. Facility has one

entrance/exit point. Facility staff observed with facial coverings. Facility has no obstruction or fire clearance

issues. Hand sanitizer was readily available to residents and visitors. Hand washing and other various

Covid-19 related signs were observed in the common areas. Sharp items and medications are locked in the

Kitchen cabinet. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Cleaning supplies and chemicals are locked in the office. Fire extinguisher in the kitchen was last serviced on 6/29/2022 and was fully charged. Trash cans observed with lids. Hand washing posters were observed in the bathrooms by the sink. Medication observed to be locked in the hallway cabinets. A sample of medication was reviewed. Staff and resident records were reviewed for updated emergency contact information and health screening.

No deficiencies issued during this inspection.

LPA is requesting the following documents be submitted to the Fresno CCL office by 2/14/2023: Current copy

of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization

(LIC309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan

(LIC610E), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.

An exit interview was conducted with Administrator. Report signed on-site and printed copy provided.