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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206544
Report Date: 12/20/2021
Date Signed: 12/22/2021 08:40:24 AM

Document Has Been Signed on 12/22/2021 08:40 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:REHABILITATION CENTRE OF FRESNOFACILITY NUMBER:
107206544
ADMINISTRATOR:BAINS, AMANFACILITY TYPE:
740
ADDRESS:1665 M STTELEPHONE:
(559) 268-5361
CITY:FRESNOSTATE: CAZIP CODE:
93721
CAPACITY: 70CENSUS: 32DATE:
12/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Administrator, Aman BainsTIME COMPLETED:
01:03 PM
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On 12/20/2021, Licensing Program Analyst, M. Garza arrived at the facility unannounced to conduct the required Infection Control Inspection.LPA observed a central entry point with a supply of hand sanitizer and a sign in policy that includes documented routine symptom screening for resident's, staff and visitors. LPA granted entry in to the facility. LPA was greeted by Administrator, Aman Bains and toured facility. Residents observed in common areas, in rooms and in the hallways.

Mitigation plan was received. COVID-19 procedures described in the plan include required postings, symptoms screenings (for staff, persons in care and visitors), testing, quarantine/isolation cohorts, infection control plan to include donning and doffing of Personal Protective Equipment. Staffing and sick leave plans are in place for emergency staffing and/or PPE shortages.

Required postings of signs to include hand washing and physical distancing were observed throughout the facility. Staff were all observed wearing face coverings. Facility has designated visitation areas. Covered trash bins were observed. LPA observed a 30 day supply of PPE and resident medications. Sinks are well stocked and liquid soap for hand washing and paper towels for hand drying were observed.

Through LPA observation of documentation and interview with Administrator and staff, the required infection control practices are found to be in compliance. No deficiencies cited on todays inspection. A technical advisory was discussed for the coughing and sneezing etiquette.

Due to COVID precautionary measures a copy of this report will be emailed to: administrator.al@hcfresno.com. A delivered and read receipt serves as confirmation.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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