Facility Evaluation Report

On 11/16/21 at 12:00PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an infection control annual inspection and explained the purpose of the visit with administrator (ADM). LPA observed no residents or staff at the home during visit.

LPA inspected the facility inside and outside. Facility has a mitigation plan in place dated 11/2020 to mitigate the spread of COVID-19. LPA discussed the completed mitigation plan (LIC 808) with ADM as well as COVID-19 infection control practices. One central entry point has been designated for universal entry screening with the station located near the front entrance with visitor's log, hand sanitizer, face masks and no touch temperature probe. COVID-19 signs were observed posted in the common hallway to promote handwashing, cough/sneeze etiquette and physical distancing.

ADM stated facility will document daily temperatures and COVID-19 symptom checks for staff and residents once they have residents. Pathways were observed to be free of obstruction and fire hazards.