Routine inspection·January 19, 2023

On 01/19/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced at 09:04 am 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. Ravi Stephen, Administrator was called, stated unable to attend meeting and authorized Care Coordinator (CC) Shannon Steele to receive and sign report. CC arrived shortly and conducted tour with LPA. All six residents were present during the inspection. Upon entry facility staffs 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 with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. LPA observed COVID-19 relate signs and cough etiquette posting in facility. Food supply was checked and appeared to be an adequate supply. Cleaning supplies were stored and locked in cabinet in the garage and under kitchen sink. LPA and CC 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. LPA observed 4 bedrooms that are single occupant and 1 shared resident’s bedroom to be at least 6 feet apart.The exterior tour was conducted. Side gate was self-closing and self-latching. Staff records were reviewed for good health. All residents’ records reviewed to have updated emergency contact information. LPA checked residents’ locked medications and observed 30-day PPE supplies. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 1/25/23. The following updated forms were requested: Lic 308, Lic 400, Lic 402, Lic 500, Lic 610E,Lic 808, Lic 9282, current liability insurance, and current Administrator certificate. A copy of this report and appeal rights was provided to Care Coordinator via email. Report signed on site.