Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo conducted an unannounced infection control annual inspection. LPA met with Daphna Garcia, administrator, and informed the purpose of visit. LPA also met with other staff, Sharon Blackwell.

Facility has an approved LIC808 Mitigation Plan on file. All 3 staff were fit tested for N95 respirator; 2 on June 25, 2021 and the other staff on July 21, 2021. Daphna stated they will re-fit tested by next month.

LPA inspected the living room, dining area, kitchen, bathrooms, family/recreation room, side and backyard. There's adequate food supplies of perishables good for 2 days and non-perishables good for 7 days.

LPA observed screening station located near the front entrance with visitor's log, hand sanitizer and no touch probe thermometer. Surgical masks and disposable gloves are readily available at the screening station. Visitor's temperature and symptom checking are done at entry for visitors. Residents and staff are screened for COVID-19 symptoms, and temperature is checked daily; however, facility does not keep record for the staff. Facility check for proof of vaccination of visitors and antigen test kits are readily available. COVID-19 signages were observed posted all throughout the facility. Supplies of PPEs were checked.

Hot water temperature in one of common bathrooms was tested and measured at 110 degrees Fahrenheit. Fire extinguishers checked and observed fully charge with tags showed serviced August 3, 2021. The two-in-one smoke and carbon monoxide detector was tested and observed operational.