Routine inspection·April 6, 2022

On 04/06/22, 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 Ricky Padual. LPA conduct tour of facility with caregiver. Administrator Sundari Kendakur (Susan) was called and arrived shortly during tour. Six residents were present during the inspection. Upon entry facility staffs was observed with facial covering. 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. Social distancing and cough etiquette postings were observed. LPA checked residents’ locked medications. Food supply was checked and appeared to be an adequate supply. LPA observed fire extinguisher served date: 5/7/22. 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 bed to be at least 6 feet apart. 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 bathroom sinks. LPA observed 30-day PPE supplies. Cleaning supplies were stored and locked in cabinet in the garage. LPA and Administrator observed a staff pull out bed in laundry room. The exterior tour was conducted. Side gate was self-closing and self-latching. Staffs records were reviewed for good health and infection control training. All resident records reviewed to have updated emergency contact information. 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: 4/12/22. The following updated forms were requested: Lic 308, Lic 309, Lic 400, Lic 402, Lic 500, Lic 610E, Lic 9020, control of property, and current liability insurance. LPA received copy of Lic 808 and updated 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.