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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803940
Report Date: 11/22/2021
Date Signed: 11/22/2021 04:57:48 PM

Document Has Been Signed on 11/22/2021 04:57 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:BRIGHT YEARS CARE HOMEFACILITY NUMBER:
486803940
ADMINISTRATOR:SILVERIO, ARNELFACILITY TYPE:
735
ADDRESS:1223 ETON CTTELEPHONE:
(707) 386-3888
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 4CENSUS: 4DATE:
11/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Giorjeous Garcia, Licensee and AdministratorTIME COMPLETED:
05:10 PM
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Licensing Program Analyst (LPA) Karina Canela arrived unannounced to conduct an Annual Required - 1 Year inspection and met with Giorjeous Garcia, Licensee and Administrator. The annual inspection is focused on the Infection Control procedures and practices of this Adult Residential Facility.
LPA conducted a walk-through of the facility with Licensee and observed COVID-19 precaution postings. A screening station was observed at front entrance of facility which had hand sanitizer, a thermometer, surgical masks, and a sign-in sheet for visitors and staff. LPA was screened for COVID-19 symptoms and temperature check. Visitors are screened for COVID-19 symptoms (including temperature check) upon arrival to the facility. LPA discussed with Licensee of indoor visitation requirement of verifying COVID-19 vaccination or a negative COVID test within 72 hours for non-essential visitors. The facility has designated visitation areas, provides virtual visits and phone calls for family to stay in contact with clients. Staff's temperatures are taken upon arrival to the facility. Client's temperatures are taken twice a day; LPA observed documentation. Staff clean and disinfect the facility once per shift (3 times daily). Licensee stated high touched surface areas are disinfected after each use, such as the bathroom and kitchen area.
LPA observed 4 clients in care. Staff have documented completion on the following training: infection prevention, symptoms, transmission and PPE use. N-95 respirator Fit testing (Cal/OSHA requirement) has been completed and LPA observed documentation. The facility has a supply of PPE including gloves, face shields/goggles, N-95 respirators, surgical masks and disposable gowns.

The facility has submitted a COVID-19 Mitigation Plan Report on Epidemic Outbreaks specific to COVID-19 which was reviewed by the California Department of Social Services, Community Care Licensing.

Exit interview conducted with Licensee, whose signature on this document confirms receipt.
No deficiencies cited during this inspection
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Karina Canela
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2021
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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