<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 286803028
Report Date: 07/13/2021
Date Signed: 07/13/2021 03:58:46 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:AEGIS ASSISTED LIVING OF NAPAFACILITY NUMBER:
286803028
ADMINISTRATOR:PAUL OSESOFACILITY TYPE:
740
ADDRESS:2100 REDWOOD ROADTELEPHONE:
(707) 251-1409
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:56CENSUS: 48DATE:
07/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA), Angela Elliott and LPA Shannan Hansen, arrived unannounced to conduct an Annual inspection, today at approximately 11:00 AM, and met with General Manager Paul Oseso. The inspection is focused on the Infection Control procedures and practices of this facility.

Facility has Assisted Living, and Memory Care areas of the facility. LPA's conducted walk through with Paul Oseso, General Manager, Felicidad Ybona, Regional Nurse, Janos Tar, Maintenance Director and observed COVID-19 posters throughout both areas, including hand washing signs in public restrooms. Mitigation plan has been submitted and approved by Community Care Licensing (CCL).

Upon arrival, there is an automated Accushield screening system to measure temperature and screen visitors. All staff and visitors are required to complete the process as well as residents who are returning from the community. Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer is kept in the common areas and resident rooms at the facility except in Memory Care due to safety concerns. Per the General Manager, they regularly discuss infection control with residents and staff with memos that are posted at the facility. Family members and responsible parties are contacted via phone if there are any changes to protocols. According to General Manager staff have completed Personal Protective Equipment (PPE), infection control training and have been N-95 Fit tested. General Manager indicated they would look for training documentation and forward to LPA. Facility has 2 housekeeping staff three days a week and one housekeeping staff four days a week from 8:00 AM-6:00 PM. After hours care staff assist the residents. Facility is cleaned daily and high touch surfaces are cleaned constantly. Residents are encouraged to wear masks when outside of their rooms and staff were observed to be wearing them while in the facility.

(Continued on LIC 809-C)
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Angela ElliottTELEPHONE: (470) 717-1668
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: AEGIS ASSISTED LIVING OF NAPA
FACILITY NUMBER: 286803028
VISIT DATE: 07/13/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Residents are screened for COVID-19 symptoms, staff observe for any changes. and resident's emergency contact information has been updated. Toxins are secured in a housekeeping closet and inaccessible in locked areas throughout the facility. Medications are stored in a locked medication rooms and in locked medication carts. According to Regional Nurse there are no barriers to getting medications for residents. The facility has a large supply of Personal Protective Equipment (PPE) stored in various areas throughout the facility. Facility is conducting COVID-19 surveillance testing per CCL guidelines. General Manager stated that the facility is following and operating in compliance with their approved mitigation plan.

Communal dining is occurring with social distancing. LPA and General Manager discussed client activities and visitation practices. Daily activity calendars are posted in both areas of the facility. Activities include Exercise, sing alongs, games, news, patio activities and movies in the activity room. Currently visits are happening in resident rooms, other areas of the facility except the dining room and off campus.

Administrator and LPA discussed their Emergency Disaster Plan.

No deficiencies cited during this inspection.
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Angela ElliottTELEPHONE: (470) 717-1668
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2