Disease outbreak check·August 8, 2023

On 08/08/2023, an unannounced collaborative visit was made to El Rio Memory Care by Licensing Program Analyst, (LPA) Kimberly Viarella, and representatives from Stanislaus County Public Health Department, Zaurina Jones, Pubic Health Nurse, and Gorlia Xiong, Medical Investigator. The LPA identified herself and her colleagues and asked to speak with the Executive Director. The group explained the purpose of their visit was to provide technical support in addressing the recent scabies outbreak. This visit was informational and educational. The team met with the Kent Mulkey, Executive Director, Karan Bassi, the Director of Nursing Staff, and Carlin Robertson, the Campus Business Office Manager. The Director of Nursing shared the current practices and procedures that were being implemented to address and prevent the spread of scabies. The Public Health representatives shared strategies for improving these procedures and offered additional suggestions to assist with eradicating scabies from the facility. The following is a partial list of practices that the team developed after the above meeting and tour of the facility. A complete report will be delivered at a future date by these public health officials. These are suggestions based on the unique needs of this facility. Some of these suggestions are already being implemented to a certain degree. It is hoped that the staff at El Rio would include them as they develop and implement their own customized infection control plan. Separate those who have never been treated / shown symptoms from those who have been treated /shown symptoms as much as possible. Utilize a different dining / activity room for each group. This would assist in preventing new cases. Another option would be to stagger the times for dining and activities, but this would require a thorough deep cleaning and vacuuming between each session which may/may not be possible. Enhance environmental cleaning procedures. Utilize disposable mop and dust heads. Color code laundry bags to indicate which laundry / bedding belongs to a resident who is being treated for scabies. Only launder exposed items with other exposed items. PPE Staff assisting with the showering, changing, and / or toileting needs of residents, would wear PPE (gowns and gloves). Staff assisting with walking a resident somewhere or helping with an activity would wear gloves to prevent skin to skin contact. Bilingual signs explaining donning/doffing would be posted for staff to review as needed. PPE would be kept outside of resident’s rooms with some type of child lock to prevent residents from disturbing or taking items. Another option would be to keep PPE at the Nurse’s station of some other designated area that would be centrally located and easy for staff to access. Communication It was encouraged by the team that signage be posted in the lobby regarding potential exposure to scabies upon entering the community. Public Health also shared a template of a letter that could be utilized to share this information with the family members and responsible parties for all the residents in care. Public Health also suggested developing questionnaires to assist in gathering information from those who have visited or who intend to visit the facility. LPA conducted an exit interview with the El Rio representatives and a copy of this was provided. No citations cited during this visit.