Facility Evaluation Report

On 03/09/22 at 09: 05 am Licensing Program Analysts (LPA) J. Clancy-Czuleger and K. Nguyen arrived unannounced to conduct infection control inspection LPAs meet with Licensee Orlando Fajardo and explained the purpose of the visit.

During the Infection Control Inspection, LPAs toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen, and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. 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. Hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. The facility has a mitigation plan. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks.

The following deficiency was observed during the visit:

LPAs observed that the facility did not have the LIC 610

LPAs observed that the facility did not have the LIC 9020

LPAs observed chairs blocking the outdoor pathway to emergency exit

Exit interview conducted. Appeal Rights and a copy of this report provided.