Routine inspection·February 6, 2023

On 02/06/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. Facility staff contacted Administrator, Jean Asignacion, who arrived a short time later. LPA conducted a facility tour with Administrator. COVID-19 guidelines are not in place. Facility appeared cleaned. LPA observed multiple bikes, a basketball court, bed frames, multiple pieces of wood and other items blocking the self-latching gate and emergency exit door in the dining area. Hand sanitizer was readily available to residents and visitors at facility entrance. Social distancing is maintained in the common and dining areas. Bathrooms did not have trash cans with lids. Hand washing posters were not observed by the bathroom sink. Bedrooms are single occupant. There is one shared bedroom, beds in the shared bedroom observed to be at least 6 feet apart. LPA checked residents' medications and observed a 30-day supply. Food supply was checked and there appeared to be an adequate supply. Cleaning and PPE supplies were checked. Facility staff were not observed to be wearing facial coverings. Resident’s files had updated emergency contact information. LPA is requesting the following documents be submitted to the Fresno CCL office by 02/20/2023: 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 LPA is requesting Administrator submit a copy of the facility's mitigation plan by 5:00PM today, 02/06/2023. A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed with Administrator. A copy of this report and appeal rights were discussed and provided to Administrator, Jeaan Asignacion, whose signature on this form confirms receipt of this document.