Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo conducted an unannounced infection control annual inspection. LPA met with Assistant Administrator Maria Theresa "Tek" Ordiniza, and informed the purpose of visit.

Facility has an approved LIC808 COVID-19 Mitigation Plan. The facility submitted the new Infection Control Plan which LPA received on June 30, 2022. Three staff were fit tested for N95 respirators on March 4. 2022 and other 2 on March 8, 2022. Staff Lolita Chan is still to be fit tested.

LPA inspected the facility inside out with Maria Theresa "Tek" Ordiniza. LPA observed screening station by the front entrance with visitor's log, hand sanitizer, surgical masks and no touch temperature probe. Routine symptom screening of temperature and symptoms checking are done at entry for all staff and residents and recorded daily. Centrally stored PPEs checked. There were COVID-19 signages/posters all throughout the facility and hand washing signs on all bathroom/toilets. Food supplies were observed adequate for 7 days of non-perishables and 2 days of perishables. .

Fire extinguisher inspected and observed fully charge with tag showed serviced April 25, 2022. Water temperature in one of the common bathrooms was tested and measured at 105.3 degrees Fahrenheit. Smoke detector tested and observed operational.

2. Supply of disposable gowns not sufficient for 30 days for 5 staff