Facility Evaluation Report

On today’s date, at 9:35 AM, Licensing Program Analyst (LPA) L. Fici and Licensing Program Manager (LPM) Y. Flores-Larios arrived unannounced to conduct an Annual Infection Control Visit. LPA and LPM was greeted by Administrator Mia Moe at front door entrance.

During the inspection, LPAs toured facility including but not limited to front entrance, kitchen, common areas, hand washing stations, bedrooms, bathrooms, and backyard. LPA and LPM observed COVID-19 signage throughout the facility. Hand washing signs were posted at hand washing stations. LPA and LPM observed paper supplies and PPEs are sufficient. Common areas are disinfected frequently throughout the day. Water temperature is measured at 114.3. Fire extinguisher was last serviced on 2-16-2022. Carbon monoxide and smoke detector are operable. Facility passages inside and out free of obstruction and does not pose a health and safety risk for persons in care.

During record review, LPA and LPM observed facility has a copy of their Infection Control Plan on file.

Exit interview conducted with Administrator and copy of this report provided.