Facility Evaluation Report

9/02/2021 10:00 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with licensee Bella DeLaPaz and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical mask, gloves. Additionally, LPA Knight was screened by Bella DeLaPaz, licensee.

LPA Knight and Bella DeLaPaz toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, rsix (6) resident bedrooms, four (4) bathrooms, kitchen, storage areas front yard and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA Knight and the licensee completed the infection control domain and facility was found to be in substantial compliance at this time.

No deficiencies are being cited as a result of todays inspection.

Exit interview conducted and copy of report was given to licensee Bella DeLaPaz.