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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577000881
Report Date: 07/27/2021
Date Signed: 07/29/2021 11:52:50 AM

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:ATRIA COVELL GARDENSFACILITY NUMBER:
577000881
ADMINISTRATOR:SLOAN, ASHLEEFACILITY TYPE:
740
ADDRESS:1111 ALVARADO AVETELEPHONE:
(530) 756-0700
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY:210CENSUS: 133DATE:
07/27/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Ashlee Sloan, Administrator and Giam Alviedo, Resident Services DirectorTIME COMPLETED:
05:30 PM
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On 07/27/2021 Licensing Program Analyst Jill Nakagawa performed an unannounced Annual Inspection focusing on Infection Control. Administrator Ashlee Sloan and Resident Services Director Giam Alviedo provided a tour of the facility (currently home to 133 residents), which was observed to be clean and a comfortable temperature. There was a sign-in station at the front door with staff assisting in screening and documentation. There was hand sanitizer available. Signage at the front desk included information on Infection Control regarding Covid-19. 100% of staff and residents are vaccinated All Care and Office staff were observed to be wearing masks. Residents were not wearing masks inside the building.

There is ample room in the facility for residents to be socially distant and still enjoy social events. The dining room is set up with four residents to a table. Hand sanitizer is available at the entrance for use before dining. Kitchen staff was observed to be wearing masks and there was hand sanitizer and a hand washing station available for their use.

The restrooms in the common area were outfitted with paper towels and hand soap. Hand washing signs were posted in each of the restrooms. The staff lounge also had hand washing signs in the rest room, as well as soap, hand sanitizer and paper towels.

High traffic common areas by the Cafe/Bistro and Mailboxes are cleaned and disinfected each day. Hand sanitizer is available at the counter for patrons' use. Required signs are posted by mailboxes, including Covid-19. There is ample PPE for emergency/30 day supply. Resident Services Director Giam Alviedo oversees training and surveillance testing for the facility.

Exit interview conducted with Administrator, whose signature on this document confirms receipt.

No deficiencies cited during this inspection
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Jill NakagawaTELEPHONE: 707-588-5063
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021
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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