Routine inspection·December 1, 2022

On 12/1/22, Licensing Program Analyst (LPA) Mai Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. LPA was met by caregiver Bienviel “Ben” Yap. Elisa “Lisa” Pua, Administrator was called and arrived later during inspection. LPA conduct facility tour with caregiver. All five residents were present during the inspection. Facility staffs was observed with mask on. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point. 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. COVID-19 related signs and cough etiquette postings observed in facility. LPA observed fire extinguisher served date: 10/17/22. LPA observed residents’ 30-day medication supplies in locked cabinet in kitchen. LPA observed resident’s medication bottle on kitchen counter unlock . Food supply was checked and appeared to be an adequate supply. At 08:56 AM, LPA and caregiver observed in the refrigerator in the kitchen milk with expired date: 11/24/22. LPA observed a 30-day PPE supplies. 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 3 single occupant room. All bathrooms are observed with trash cans with lid and securely fastened grab bars. Bathrooms have non-skid mat. LPA observed hand washing posting by all sinks. Cleaning supplies were stored and locked in garage. At 09:57AM, LPA and caregiver observed in the refrigerator in the garage hamburger buns with expired date: 09/14/22. The exterior tour was conducted. LPA and staff observed a paint bucket and chemical bottle outside unlocked. Side gate was self-closing and self-latching. Staff records were reviewed for good health and infection control training. All residents’ 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: 12/7/22. The following updated forms were requested: Lic 308, Lic 400, Lic 402, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Administrator.