Routine inspection·November 23, 2021

On 11/23/2021, Licensing Program Analyst (LPA) Walton arrived unannounced at the above facility to conduct an Annual Inspection. Facility has one central entry and exit point. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Administrator, LaShay Dustin Upon entry, LPA observed a visitor log-in/temperature check. Facility tour conducted. All pathways, entrances and exits were clear from obstructions. No fire clearance issues. LPA observed signs promoting hand-washing, social distancing, and cough/sneeze etiquette. Facility staff observed to be wearing facial coverings. LPA toured the facility kitchen. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. LPA observed a 30 day supply of PPE and cleaning supplies. Residents at the above facility have private rooms. Bedrooms were stocked with hand sanitizer. Facility bathrooms were stocked with paper towels and liquid soap. Hand-washing signs observed in resident bathrooms. LPA checked residents' medication and observed a 30 day supply. Resident temperature checks are documented daily. Resident records were observed to have updated Emergency contact information. Staff records were reviewed for infection control training and good health. LPA is requesting the following documents be submitted to the Fresno CCL office by 12/07/2021: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan LIC 610E, Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020A, Surety Bond, COVID-19 Mitigation Plan (LIC808). No deficiencies issued during this inspection. Exit interview conducted. As a COVID-19 precautionary measure, copy of this report will be provided via email and an electronic read receipt confirms receiving this document. Report signed on-site by Facility Representative.