Routine inspection·October 27, 2022

On 10/27/22, 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 Eddiemer “Bang” Sison, Designee and was granted entry. Administrator Innocent Idusuyi was called and stated unable to attend meeting. Administrator authorized Designee to receive and signed report. LPA conducted tour with Designee. All four residents were present during the inspection. Upon entry facility staff was observed with face mask on. 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. COVID-19 and cough etiquette postings observed. LPA checked residents’ locked medications. LPA observed fire extinguisher served date: 05/19/21. LPA observed 30 days PPE supplies. Food supply was checked and appeared to be an adequate supply. Cleaning supplies were stored and locked in cabinet in the garage. All resident’s room toured and observed to be adequately furnished and lit. LPA observed four 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 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: 11/2/22. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, Lic 9282, and current liability insurance. A copy of this report and appeal rights was provided to Designated Representative.