Teresa's Quality Comfort Care

Type of visit: Required - 1 Year

On 10/09/2023 at 12:15 PM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct Required 1 Year Annual inspection. Upon arrival LPA was greeted by caregiver, Administrator arrived at 1:00 PM. LPA met with Administrator, Salina Boatner and explained the purpose of the visit. The facility’s fire clearance was approved for 6 Non-Ambulatory which 1 may be Bedridden. LPA toured facility with Salina including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 3 total bedrooms which all 3 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 108 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last purchased on 06/18/2023. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 07/28/2023. Report continues on 809 C. At 1:10 PM, LPA reviewed 4 of 4 residents records. At 1:35 PM, LPA reviewed 5 of 5 staff records and 5 of 5 have current first aid training and associated to the facility. At PM, LPA reviewed 4 of 4 resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 10/30/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 9, 2023

Type of visit: Required - 1 Year

On 7/13/2022 at 10:00 AM Licensing Program Analyst (LPA) Leslie Ibo arrived unannounced to conduct an annual required infection control inspection. LPA met with Administrator Salina Boatner. Facility has census of 5. LPA toured the entire premises indoors and outdoors. The facility has 3 bedrooms, 2 bathrooms, one story house per facility sketch. 3 bedrooms are designated for residents only. LPA observed 1 fire extinguisher which located at the garage. Smoke detectors and carbon monoxide detectors were observed operational. LPA observed adequate lighting. Hallways and passageways were free of obstructions. Food supplies were sufficient good for 7 days of non-perishables. Linens, bed covers, hygiene and paper product supplies were observed. Knives are kept in a locked cabinet. Laundry supplies are locked in cabinets in the laundry area. First aid kit checked and showed complete with manual. No bodies of water observed. ...Continued to LIC809C... Facility has enough paper supplies and hygiene supplies. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE (mask) LPA conducted technical assistance on the following topics: Infection control plan to be submitted to CCL by 7/15/2022, PIN was provided to Administrator. LPA recommended to Administrator to modify visitors covid19 screening question. LPA discussed with Administrator about reporting requirements. LPA discussed with Administrator about visitation guidelines and latest PINs. LPA discussed with Administrator the importance of N95 Fit testing (technical assistance provided). LPA recommended to add more PPE supplies. LPA provided Contra costa SPOT link for covid19 reporting. All staff needs training on infection prevention, symptoms, transmission and PPE use by an individual trained in infection control. LPA observed that S3 does not have proof of infection prevention training. Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due dates, and any repeat violations within 12-month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with Salina Boatner. Exit interview conducted and appeal rights copy of this report provided.the state’s words, verbatim · CDSS document, Jul 13, 2022

Type of visit: Case Management - Other

On 7/16/2021 LPA L.Ibo conducted case management in continuation of the pre-licensing visit from 6/18/2021. LPA observed zero clients. LPA observed the following items were corrected: 1. LIC200 Application for a Community care facility - Corrected, LPA received revised LIC200 and LIC850 that matched the capacity of the facility. 2. Auditory signals for the doors (for dementia care) 3. Stove covers ( for dementia care) No issues noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted with Applicant Salina Baotner and a copy of report was given.the state’s words, verbatim · CDSS document, Jul 16, 2021