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25 | On 11/07/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. Facility staff contacted Administrator, John Nobleza, via telephone. Administrator arrived a short time later.
Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas.
LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Facility has an adequate supply of PPE and cleaning supplies. Staff records were reviewed for infection control training. LPA observed all facility staff wearing masks. Resident’s files have updated emergency contact information.
LPA is requesting the following documents be submitted to the Fresno CCL office by 11/21/2022: 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 (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond
No deficiencies issued during today's visit. Exit interview conducted. A copy of this report was discussed and provided to Administrator, John Nobleza, whose signature on this form confirms receipt of this document.
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