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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530038
Report Date: 02/17/2023
Date Signed: 02/17/2023 03:45:54 PM

Document Has Been Signed on 02/17/2023 03:45 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SUMMERFIELD OF REDLANDSFACILITY NUMBER:
365530038
ADMINISTRATOR:GORMLEY, DANIELFACILITY TYPE:
775
ADDRESS:1319 BROOKSIDE AVENUETELEPHONE:
(509) 793-9500
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY: 45CENSUS: 40DATE:
02/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Office Staff at Front DeskTIME COMPLETED:
03:55 PM
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Licensing Program Analyst, Amber Coleman (LPA) arrived at the Summerfield of Redlands facility to conduct an Annual Inspection with a focus of Infection Control. LPA walked into the lobby, introduced self to staff and stated the purpose of the visit. Staff Member introduced himself as Jonathan Guzman, Business Office Manager. LPA that the Administrator has left for the day. Facility Nurse stated she would make herself available to give LPA walkthrough. LPA was asked to sign in and provided a place to work. The current census is 40 residents. At this time there are no concerns for staff or residents with a current COVID diagnosis.

LPA completed walk through of the facility with staff member and nurse. LPA interviewed staff pertaining to the facility's infection control measures and other health and safety concerns. LPA observed necessary signs posted in the facility, including signs related to COVID-19, which were in accordance with the Department's guidelines. Nurse stated that the facility is equipped with sufficient PPE, hand hygiene supplies, and sufficient cleaning/disinfecting provisions. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in adequate quantities, and that staff are trained in the facility's infection control measures. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolation of residents, and properly caring for residents with COVID-19 positive results and/or exposures. The facility also has a plan in place to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician and emergency personnel in the event the resident presents any COVID-19 symptoms.

LPA observed 4 bathrooms, each was equipped with adequate amounts of handsoap, hand washing signage and paper products. Smoke and Carbon Monoxide Alarms were observed throughout the facility. Fire Drills are conducted on a monthly basis. Last fire drill conducted in Jan.2023.

Inspection Tool was utilized, Mitigation plan was reviewed. Facility was further inspected, and no deficiencies were noted. An exit interview was conducted where a copy of this report was provided to Facility Representative.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2023
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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