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25 | On 01/25/2023, Licensing Program Analyst (LPA) Walton 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. Facility Staff contacted Administrator via telephone. Administrator, Marc Barcelona, arrived a short time later.
LPA conducted a facility tour with Administrator. COVID-19 guidelines are in place. Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer was readily available to residents and visitors at facility entrance. Social distancing is maintained in the common and dining areas. Bathrooms have trash cans with lids. Hand washing posters were observed by the bathroom sink. There are three single occupant bedrooms and 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 was observed with facial coverings. Resident’s files had updated emergency contact information.
LPA is requesting the following documents be submitted to the Fresno CCL office by 02/08/2023: 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
No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Marc Barcenlona, whose signature on this form confirms receipt of this document.
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