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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336425681
Report Date: 10/10/2022
Date Signed: 10/11/2022 10:36:49 AM


Document Has Been Signed on 10/11/2022 10:36 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:STARLIGHT SENIOR LIVINGFACILITY NUMBER:
336425681
ADMINISTRATOR:DANA MATEIFACILITY TYPE:
740
ADDRESS:13718 OVERLOOK DR.TELEPHONE:
(760) 288-7351
CITY:DESERT HOT SPRINGSSTATE: CAZIP CODE:
92240
CAPACITY:5CENSUS: 4DATE:
10/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Dana Matei, Administrator TIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Tricia Danielson arrived unannounced to the facility to conduct an annual inspection with emphasis on infection control. LPA met Caregiver Laura Baca and explained the purpose of today’s visit. Administrator Dana Matei arrived shortly thereafter. The facility has submitted a Mitigation Plan Report as well as an Infection Control Plan as required.
During the inspection, LPA observed appropriate COVID-19 postings throughout the facility. The facility has a COVID-19 symptom and temperature screening process in place which was in accordance with the Department's guidelines. LPA observed that the facility was also equipped with sufficient hand hygiene supplies, sufficient cleaning/disinfecting provisions, and a supply of Personal Protective Equipment (PPE). As documented in the Infection Control Plan, the facility has a designated infection preventionist who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring staff are trained in the facility's infection control procedures, and ensuring infection control measures are implemented. Also, the facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolation, and properly caring for residents and staff with COVID-19 positive results and/or exposures. Additionally, as documented in the Infection Control Plan, the facility has a plan to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician, emergency personnel, and responsible party in the event the resident presents with any COVID-19 symptoms. Based on today's observations, the facility is following the Infection Control Plan.

No deficiencies were cited during today's visit. An exit interview was conducted and a copy of this report was provided along with LIC 9102- Technical Assistance.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Tricia DanielsonTELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2022
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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