Routine inspection·June 13, 2022

On 6/13/22, 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 Ralphchris “Ralph” Valencia, Caregiver. Administrator Carlo Santos was called and arrived shortly and conduct tour with LPA. All five residents were present during the inspection. Upon entry facility staff 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 observed. LPA checked residents’ locked medications. LPA observed small amount of PPE supplies in facility. Food supply was checked and appeared to be an adequate supply. LPA and Administrator observed fire extinguisher served date: 07/22/19. All resident’s room toured and observed to be adequately furnished and lit. LPA observed 1 shared residents’ bed to be at least 6 feet apart and 4 single occupant room. All bathrooms are observed with securely fastened grab bars and non-skid mat. All bathrooms observed trash bin with lid. Hand washing posting not observed by bathroom sinks. The exterior tour was conducted. Side gate was self-closing and self-latching. Staff 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: 6/20/22. The following updated forms were requested: Lic 308, Lic 309, Lic 500, Lic 610E, Lic 9020, and control of property. LPA received copy of current liability insurance and administrator certificate. A copy of this report and appeal rights was provided to Administrator.