Facility Evaluation Report

On 11/3/2022 at 10:00AM, Licensing Program Analysts (LPAs) G. Luk and L. Alexander arrived unannounced to conduct an Infection Control Inspection. LPAs met with caregiver, Angela, Dela Cruz and explained the purpose of the visit. Administrator, Alicia Peacock arrived 30 minutes later

Upon entry, staff did not conduct COVID-19 screen for LPAs. LPAs observed hand sanitizer at screening station. LPAs toured facility including but not limited to residents' bedrooms, bathrooms, kitchen, dining area, garage, and outdoor areas. LPAs observed physical distancing, signs & symptoms, and mask wearing posted in the common areas. All bathrooms were equipped with soap and paper towel. Hand washing posters were posted at bathrooms and sinks.

During record review, LPAs observed visitors log and temperature logs. LPAs observed facility has a copy of Mitigation Plan on file. Staff completed FIT testing for N95 respirators and have completion documents. LPAs observed PPE, food supplies, and paper supplies are sufficient.

At 10:14AM, LPAs observed unlocked medications in the kitchen cabinet. Staff locked up the medications during visit.

At 10:20AM, LPAs observed keys were on the locked knives drawers and accessible. LPAs observed unlocked lighters, laundry detergent, and cleaning supplies. Staff locked up the items during inspection.