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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005215
Report Date: 08/16/2021
Date Signed: 08/16/2021 12:46:57 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:ABUNDANT LOVE AND CARE FOR THE ELDERLYFACILITY NUMBER:
347005215
ADMINISTRATOR:BONITE, VIRGINIAFACILITY TYPE:
740
ADDRESS:2607 WALNUT AVENUETELEPHONE:
(916) 481-6817
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 6DATE:
08/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Virginina Bonite, Administrator TIME COMPLETED:
12:45 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) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask. There are (6) residents at the facility and no residents are currently receiving hospice services.

LPA observed a resident to be finishing eating breakfast in the main room at the start of the inspection. LPA observed that (4) residents were napping during the inspection and (2) were watching television in their rooms. LPA and caregivers toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, (2) shared resident bedrooms, (1) private bedroom, (1) restrooms, kitchen, dining room, laundry area and staff room . In the areas toured no immediate health, safety, or personal rights violations were observed. LPA observed sufficient food and PPE supply. LPA and caregivers completed the infection control domain and facility was found to be in compliance at this time. Inside temperature was observed to be 74* F. Copy of current insurance liability policy obtained.

Staff (2) that are not vaccinated will be tested weekly per new department guidance. Administrator to provide confirmation of staff testing by Friday, 8/20/2021. Administrator and LPA discussed contacting public health for testing information and the Ombudsman regarding a non-compliant resident.

There were no deficiencies cited as a result of todays inspection.

Exit interview conducted with Administrator, caregiver, and copy of report left at the facility.



SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021
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 1