Routine inspection·April 21, 2022

On 04/21/2022, Licensing Program Analyst (LPA) 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 granted entry to the facility by Caregiver, Tina Wonderly who contacted Administrator, Amardeep Dhillon. Administrator arrived a short time later. There are 4 residents present during today's inspection. 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. Bathrooms have trash cans with lid. Hand washing posters were not observed by the bathroom sinks. 2 bedrooms are single occupant and 2 bedrooms double occupant. In the shared bedroom, LPA observed the beds to be at least 6 feet apart and 3 feet apart with head to toe orientation. LPA checked residents’ locked medications and observed a 30-day supply. Food supply was checked and there appeared to be an adequate supply. LPA observed a foul odor in the pantry from a bag of onions that had sprouted. The onions had attracted several gnats which were observed in the facility pantry. Administrator had the box of onions removed. Cleaning and PPE supplies were checked. Staff records were reviewed for good health and infection control training. Facility staff was observed with mask on. Residents wear masks when away from the community. Resident’s files have updated emergency contact information. LPA observed 2 out of 4 residents did not have an Admission agreement with the facility. LPA is requesting the following documents be submitted to the Fresno CCL office by 05/05/2022: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond CONTINUED TO LIC809C Based on observation a deficiency is being cited in accordance with the California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview was conducted and a Plan of Correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to Administrator, whose signature on this form confirms receiving this document.