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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206724
Report Date: 06/09/2021
Date Signed: 06/09/2021 03:48:44 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:HERITAGE LIVINGFACILITY NUMBER:
157206724
ADMINISTRATOR:TINA MALHIFACILITY TYPE:
740
ADDRESS:3801 PASEO AIROSATELEPHONE:
(661) 665-1381
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:6CENSUS: 5DATE:
06/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:29 PM
MET WITH:Licensee, Tina Malhi & Loree MalhiTIME COMPLETED:
03:30 PM
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On 06/09/2021, Licensing Program Analyst,(LPA) L. Salazar arrived at the facility unannounced to conduct the required Infection Control Inspection. LPA was greeted by Licensee Tina Malhi and House Manager Loree Malhi. LPA was allowed entry into the facility. LPA observed a central entry point with a supply of hand sanitizer. Staff enter facility from the the front door and wash hands in a bathroom located by the front door. A sign in policy that includes documented routine symptom screening for visitors is currently being implemented now that visitation restrictions have been lifted.

Mitigation plan was reviewed and approved on 06/07/2021. COVID-19 procedures described in the plan include required postings, symptoms screenings (for staff, persons in care and visitors), testing, quarantine/isolation cohorts, infection control plan to include donning and doffing of Personal Protective Equipment (PPE). Staffing and sick leave plans are in place for emergency staffing and/or PPE shortages.

LPA toured the facility inside and out. Required postings of signs to include hand washing, coughing etiquette and physical distancing were observed throughout the facility. Staff were all observed wearing face coverings. Facility has designated visitation areas. Covered trash bins were observed. LPA observed a 30 day supply of PPE and resident medications. Sinks are well stocked and liquid soap for hand washing and paper towels for hand drying were observed.

Through LPA observation of documentation and interview with Administrator and staff, the required infection control practices are found to be in compliance. No deficiencies cited on todays inspection.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) -65-7914
LICENSING EVALUATOR NAME: Lisa SalazarTELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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