Hummingbird Hill

Type of visit: Required - 1 Year

On 09/06/23 at 10:22 a.m. Licensing Program Analyst (LPA) Cheryl Goodrich arrived to conduct an unannounced annual visit. LPA met with Administrator Chris Conklin 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. The facility is approved for five (5) residents, with 0 residents in care. 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 has 2 bedrooms, and 2 bathrooms, living room, kitchen, and backyard. The bedrooms are furnished with night stand, lamp, and closet space. The beds are clean and have clean linens and the pathways are clean and clear of obstruction. The living room and kitchen clean and clear of obstruction. The medications are stored in a lockbox in the kitchen and inaccessible to residents. The RCE and has a current fire clearance for the facility, smoke and carbon monoxide detectors and fire extinguishers and are in working order. (Continued on LIC809-C) (Continued from LIC809) Personnel Records-Training: There are currently no staff working at the facility due to no residents in care other than the Administrator. The previous staff records were completed with fingerprint clearance, Health screening for TB, CPR/First Aid training, and in-service trainings. Client Records-Incident Reports: There are no residents in care currently and there have been no residents since 2019. The previous resident records were complete with pre-assessments, identification and emergency contacts, admission agreements, doctor’s orders, and additional assessments. Client Rights-Information: The resident rights information present and on file available for staff and residents. 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: There is no dispensing of medication due to no residents in care, however medication lock box is present with facility medication logbook. Disaster Preparedness: The facility has a disaster plan and has posted the evacuation plan, visible for staff and residents. The facility has emergency supply of food and water. Summary: Based on today's visit, no deficiencies were observed at this time. An exit interview was conducted with Administrator Chris Conklin and a copy of this report was printed Signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Sep 6, 2023

Type of visit: Required - 1 Year

On August 29, Licensing Program Analyst (LPA), Venus Mixson arrived at the above facility for an unannounced required annual with emphasis on infection control. LPA Mixson was greeted and granted entry by Assistant Administrator, Chris Conklin. Present in the facility were 0 residents and 1 staff. There are currently no cases of COVID-19 within the facility. LPA Mixson toured the facility and made observations pertaining to the facility's infection control measures. LPA observed sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions and the proper use of face coverings. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, and cleaning and disinfection provisions are in adequate quantities. LPA Mixson later discussed infection control practices and procedures with Assistant Administrator. An exit interview was conducted and a copy of this report, along with the LIC 811, was provided to Assistant Administrator.the state’s words, verbatim · CDSS document, Aug 26, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Kristina Ryan conducted an unannounced annual required licensing inspection. LPA was granted entry and met with Administrator, Chris Conklin. LPA was granted entry after identifying herself and disclosing the purpose of the visit. An overall tour of the facility was conducted inside and out. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other written requirements that are most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. LPA reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC 808) with Ms. Conklin, including the following sections: Person in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility has plans for infection control and physical distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention, and essential health and safety. Facility currently has no residents in care and is not planning on accepting any new residents at this time. LPA observed one central entry point for universal entry screening, hand sanitizer/hand washing stations readily available; a designated visitation area; and an adequate supply of PPE. The facility in in compliance with and has implemented infection control practices as outlined in its LIC 808. Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Ms. Conklin. A copy of this report, along with the Licensee Rights (9058 01/16) was emailed to the administrator at the conclusion of the visit, an electronic response confirms the receipt of these documents.the state’s words, verbatim · CDSS document, Sep 10, 2021