Facility Evaluation Report

On 12/16/2022 at 1:10 PM, Licensing Program Analysts (LPA) L. Fici arrived unannounced to conduct an Infection Control Inspection. LPA was greeted and met with Rosealinda, Amacan, administrator (ADM) and explained the purpose of the visit.

Upon entry, LPA's temperature was checked and was asked screening questions. LPA observed hand sanitizer at screening station. LPA toured facility including but not limited to bedrooms, bathrooms, common areas, kitchen, garage, and outdoor area. LPA observed cough etiquette, physical distancing, and signs & symptoms posted in the common areas. All hand washing stations were equipped with soap, paper towel and garbage can with a lid. Hand washing signs were posted at sinks and bathrooms. Facility has a 2-day perishable and 7-day non-perishable food supply. Fire extinguisher is maintained and was last serviced on 2/28/2022. Facility room temperature is maintained at 71 Degrees F. Hot water temperature is maintained at 105.5 Degreed F.

During record review, LPA observed a copy of their infection control plan, along with their disaster plan on file.

Exit interview conducted with administrator, and a copy of this report provided.