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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005215
Report Date: 08/31/2022
Date Signed: 08/31/2022 02:18:07 PM


Document Has Been Signed on 08/31/2022 02:18 PM - 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, 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: 4DATE:
08/31/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Virginia Bonite, Administrator TIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required case management inspection. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. LPA observed caregiver, Maria Maciuca, also present during today's 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. 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 (4) residents at the facility and no residents are currently receiving hospice services. LPA toured the facility and observed all residents to be in their rooms and the facility to be clean and in good repair.

LPA and Administrator reviewed the training binder containing documentation of monthly trainings pursuant to the order dated 2/7/2022. LPA observed monthly trainings completed for (3) staff for June, July and August 2022. Each training lasts 2 hours. Training agenda is signed by each staff and printed certificates are also in the binder. Staff will typically complete their training from 1-3:00 pm after lunch is concluded.

There are no deficiencies issued today. LPA advised there will be a subsequent quarterly case management inspection on/around December, 2022.

LPA provided some individual bottles of sanitizer and a package of disposable gowns from CCLD during today's inspection. LPA also provided a flyer for information on how to obtain a Covid-19 booster vaccination.

Exit interview. Copy of report printed for Administrator.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2022
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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