Facility Evaluation Report

On 12/05/24 at 2:30PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. ADM has a current administrator certificate # 7022561735 which expires on 06/10/2026.

At 2:40PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply in the kitchen refrigerator/freezer & fresh fruits on the kitchen island. LPA also observed additional 7-day non-perishable food supply in the garage. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 114 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and last inspected on 05/10/24. LPA reviewed 4 staff and 5 client files.

Updated copies of the following documents were collected for facility file:

 LIC308- Designation of Facility Responsibility

 LIC610D- Emergency/Disaster Plan including infection control plans

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided .