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25 | On 08/11/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to met with the Administrator. Facility staff contacted Administrator via telephone. LPA received verbal permission to begin the inspection with Caregiver. Administrator arrived a short time later.
Facility tour conducted with Caregiver, Noimi Bacani. 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. Facility had an adequate supply of food. LPA observed an adequate supply of PPE and cleaning supplies.
Resident bedrooms are single occupant and were stocked with hand sanitizer. Facility bathrooms were stocked with paper towels and liquid soap. Hand-washing signs observed in resident bathrooms. LPA checked residents' medication and observed a 30 day supply. Resident temperature checks are documented daily. Resident records have updated emergency contact information. Facility staff records reviewed for good health.
LPA is requesting the following documents be submitted to the Fresno CCL office by 08/25/2022: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond
No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Carlo Santos, whose signature on this form confirms receipt of this document.
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