Routine inspection·August 19, 2022

On 08/19/22 Licensing Program Analyst (LPA) M. Yang arrived unannounced at the above facility. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. LPA met with Marcos Garcia, caregiver. Administrator Sundari Susan Kendakur and Shannon Steele Care Coordinator (CC) was called and arrived shortly. LPA conduct tour with Administrator. Four residents were present during the tour. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point. Facility staff was observed with mask on. Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Staff records were reviewed for good health and infection control training. Food supply was checked and there appeared to be an adequate supply. LPA checked residents’ locked medications and observed a 30-day PPE supplies. Fire extinguisher observed served date 06/01/22. All bathrooms are observed with trash cans with lid and securely fastened grab bars. There are non-skid mat in the bathrooms. LPA observed hand washing posting in all bathroom sinks. All bedrooms are single occupant. Approximately at 11:46 AM, LPA, Administrator, and CC observed inside unlocked garage laundry detergent. The exterior tour was conducted. Side gate was self-closing and self-latching. All residents 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 was conducted. The following documents are requested and submitted to Fresno CCL by: 8/26/22. The following updated forms were requested: Lic 308, Lic 309, Lic 500, Lic 610E, and current liability insurance. LPA received copy of Lic 9282. A copy of this report and appeal rights was provided to Administrator via email. Signed report on file.