Routine inspection·December 3, 2021

This is an amended report. On 12/03/2021, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with administrator. LPA met with John Trinos, Caregiver. LPA toured facility with caregiver. Luijean (Jean) Abragan Designated representative and Ravi Stephen Administrator was called and arrived shortly during tour. All six residents were present during the inspection. Upon entry facility staff was observed with mask on. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to residents and visitors. Facility has one entrance/exit point. Facility appeared cleaned. Social distancing is maintained in the common and dining areas. LPA observed social distancing and cough etiquette postings in facility. LPA observed fire extinguisher served date: 05/07/21. All bathrooms are observed with securely fastened grab bars and non-skid mat. All bathrooms observed trash bin with lid. LPA observed hand washing posting by all sinks. All resident’s room toured and observed to be adequately furnished and lit. LPA observed 4 bedrooms that are single occupant and 1 shared resident’s bedroom to be at least 6 feet apart. LPA observed in bedroom 5 exit door blocked by dresser with television on top. LPA checked residents’ locked medications and observed a 30-day PPE supplies. Food supply was checked and appeared to be an adequate supply. Cleaning supplies were stored and locked in the garage. The exterior tour was conducted. Side gate was self-closing and self-latching. Staff records were reviewed. 3 out of 3 staff that were present during inspection did not have current CPR certification. All residents’ records reviewed to have updated emergency contact information. Deficiencies are being cited on the attached 809Ds in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested to be submitted to Fresno CCL by: 12/9/21. LIC 308, LIC 500, LIC 9020E. LPA received copy of Administrator Certificate during facility inspection. Administrator was informed that as COVID-19 precautionary measure, this report and appeal rights will be provided via email. Report signed on-site.