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Inspection visit

Routine inspection

EVERGREEN RESIDENCELicense 5472011201 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 10/04/22, 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 Martha Brewer, Assistant Administrator (AA) upon entry. AA stated Administrator not available to attend meeting. LPA conduct tour with AA. All residents were present during the inspection. Upon entry facility staff was observed with facial covering. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to residents and visitors. Bathroom designated for hand washing by front entrance. 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. Social distancing and cough etiquette postings were not observed. Food supply was checked and appeared to be an adequate supply. LPA checked residents’ locked medications. LPA observed 30 days PPE supplies. LPA and AA observed six fire extinguisher served date ranges from 11/03/2021 through 08/27/2020. Resident’s room toured and observed to be adequately furnished and lit. LPA observed shared residents’ bed to be at least 6 feet apart. All bathrooms are observed with securely fastened grab bars. LPA observed bathrooms trash bin with no lid. Hand washing posting observed by bathroom sinks. Outside tour and observed clear and free of debris. Staff records were reviewed for good health and infection control training. Half of the resident records were reviewed and have updated emergency contact information. A deficiency is being cited on the attached Lic 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: 10/10/22. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, Lic 9282, Administrator Certificate, and current liability insurance. A copy of this report and appeal rights was provided to the Assistant Administrator.

Citations

1 citation recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87405(d)(2)Type A

    Based on observation, LPA and Administrator Assistant observed five out of six Fire Extinguisher serviced date expired: Fire Extinguisher 1 has a service date of 8/02/2021, Fire Extinguisher 3 serviced date of 08/02/2021, Fire Extinguisher 4 serviced date 08/02/2021, Fire Extinguisher 6 serviced date of 08/27/2020, Fire Extinguisher 7 serviced date of 08/02/2021 which poses an immediate health and safety risk to the residents.

FAQ · About this visit

Common questions about this visit

What happened during the October 4, 2022 inspection of EVERGREEN RESIDENCE?

This was a inspection inspection of EVERGREEN RESIDENCE on October 4, 2022. 1 citation were issued: 1 Type A (serious).

Were any citations issued to EVERGREEN RESIDENCE on October 4, 2022?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "Based on observation, LPA and Administrator Assistant observed five out of six Fire Extinguisher serviced date expired: ..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.