Our Family Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cheryl Goodrich arrived at 9:43 AM. to conduct an unannounced annual visit. LPA met the Administrator Brian Coday at the front door and was granted entry. The purpose of today’s visit is to inspect the facility to ensure that the facility is following California Code of Regulations, Title 22, Division 6. Facility is approved for six (6) non-ambulatory residents with 5 non-ambulatory residents in care. The facility has hospice waiver. Infection Control: The facility has an approved infection control plan and a surplus of supplies for infection control including but not limited to mask, gloves, gowns, first aid kit, and cleaning supplies. Physical Plant and Environmental Safety: The facility temperature read at 74 degrees. The facility consists of 3 resident bedrooms, and 2 bathrooms, living room, kitchen, 1 staff bedroom and backyard. The bedrooms are furnished with tv, lighting, closet space, and dresser. The beds are clean and have clean linens and the pathways are clean and clear of obstruction. The bathroom temperature read at 107.6 degrees within regulation requirements. The living room and kitchen clean and clear of obstruction. The medications are stored in a locked cabinet in the kitchen and inaccessible to the resident. The facility and has a current fire clearance, smoke and carbon monoxide detectors and fire extinguishers and are in working order. Personnel Records-Training: The staff records are completed with fingerprint clearance, Health screening for TB, CPR/First Aid training, and in-service trainings. Client Records-Incident Reports: The facility has pre-placement appraisal, identification and emergency information, physician’s report, resident appraisal, hospice documentation, client rights, and admissions agreement. (Continued on LIC809-C) (Continued from LIC809) Client Rights-Information: The facility has client rights information posted in the facility. Food Service: 7-day non-perishable and 2 day of perishable food supply was observed, and all food was properly stored and available. Health- Related Services: The facility has a medication logbook, and the facility documented the resident’s medication and in compliance with physician’s orders and regulations. Disaster Preparedness: The facility has a disaster plan and has posted the evacuation plan, visible for staff and residents in care. The last fire drill was completed 08/01/23 at 9:30 AM. The facility has emergency supply of food and water. Items Discussed: Resident R2 and R5 do not have current physicians reports. Summary: Based on today visit, a deficiency is being cited. An exit interview was conducted and a copy of this report was provided to Administrator Brian Coday. LPA provided a copy of his Appeal Rights and his signature on this form acknowledges receipt of these rights.the state’s words, verbatim · CDSS document, Sep 28, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janira Arreola, made an unannounced visit on 10/19/2022 at 10:35 a.m. in order to conduct an annual visit with a focus on infection control. LPA met with Administrator, Brian Coday, who was informed of the purpose of the visit. At the time of the visit there were (2) staff and (6) residents present. LPA proceed to conduct a walk through of the facility's interior and exterior. LPA observed there was a central entry point where screenings are conducted for facility visits. LPA observed COVID-19 postings throughout the facility. The facility has a 30-day supply of PPE equipment that is readily accessible for residents and staff. The facility has a designated visitation area in the facility. LPA observed the resident bedrooms that would be used as isolation rooms. The resident bathrooms were observed to be clean and have the appropriate hand hygiene supplies such as hand sanitizer, soap, running water and paper towels. The facility has a cleaning plan in place to disinfect and clean the high touch surfaces of the facility and the isolation rooms. The staff have leave in case of contact or testing positive for COVID-19. The staff have been trained on how to properly don and doff the PPE equipment, and there is a plan of care in place to attend to those residents that would be in the isolation rooms. The staff have also been FIT tested for an N95 respiratory. No deficiencies were cited at the time of the visit. An exit interview was conducted where this report was reviewed and provided to administrator, Brian Codaythe state’s words, verbatim · CDSS document, Oct 19, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez made an unannounced visit to the facility to conduct an annual required licensing inspection. LPA identified herself and was granted entry by Brian Coday, Licensee. LPA met with Licensee Coday and discussed the purpose of today’s visit. A tour of the facility was conducted inside and out. LPA, accompanied by Licensee Coday conducted a general overall inspection, with specific focus on infection control protocols. During today's inspection LPA observations include the following: Symptom screening procedures/ for staff, residents and visitors; posted signs regarding visitor policy, promoting hand washing, cough and sneeze etiquette and other infection control procedures; Hand hygiene practices; testing plan and procedures; plans for containing infections, PPE supplies procedures and training; and disinfection procedures. Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Licensee Coday and Norlyn Coday, Caregiver. A copy of this report, along with the Licensee Rights (01/2016) were emailed to Brian Coday, Licensee at the conclusion of the visit. LPA requested for Licensee Coday to send LPA an electronic message reply confirming receipt of these documents. LPA requested Licensee Coday to submit a current Designation of Administrative Responsibility LIC 308, Personnel Report LIC 500 and Emergency Disaster Plan LIC 610-E to the licensing office within 10 business days. Forms available at www.ccld.ca.gov.the state’s words, verbatim · CDSS document, Sep 22, 2021