Facility Evaluation Report

On 09/15/21 at 2PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an infection control annual inspection and explained the purpose of the visit with administrator. LPA observed screening station located near the front entrance with visitor's log, hand sanitizer, gloves, face masks and no touch temperature probe. LPA observed 4 staff wearing face masks during visit with 2 residents watching TV in the living room. Routine symptom screening (+/-) temperature and symptom check) is done at entry for all staff, residents and visitors.

LPA observed COVID-19 signages posted in common areas to promote hand washing, cough/sneeze etiquette and physical distancing. Facility documents daily temperatures and COVID-19 symptom checks for staff and residents. Facility has a completed mitigation plan in place dated 02/11/2021 to mitigate the spread of COVID-19.

LPA discussed the completed mitigation plan (LIC 808) with administrator as well as COVID-19 infection control practices. LPA inspected the facility inside and outside. Facility has 2 living areas with furniture spaced six feet apart for social distancing among residents. Pathways were observed to be free of obstruction and fire hazards.