Facility Evaluation Report

On 0/09/23 at 05:20 PM, Licensing Program Analyst (LPA) L. Holmes arrived announced to conduct an annual Infection Control Inspection. LPA was greeted by Latashia Perry, Licensee

Facility has a COVID-19 mitigation plan, and Emergency Disaster Plan on file. Licensee has a staff roster and Emergency Disaster Plan posted. LPA observed a screening station at the entry that contained a thermometer, hand sanitizer, COVID-19 signage, and a visitor sign-in log. LPA toured the facility including, but not limited to common areas, staff room, Four (4) bedrooms, bathrooms, kitchen, front and side pathways. LPA observed mask, cough etiquette, social distancing and hand washing signs posted throughout. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap and covered garbage cans. ADM to add paper towels to shared bathroom. There is a surplus of PPE stored centrally located inside the facility that is accessible to all care staff. The facility's temperature was 69 degrees (F) and waters tested at 108.4 F. Fire extinguisher observed full. First Aid complete.

The following forms are to be updated and submitted to CCLD:

-LIC308 Designation of Administrative Responsibility (Reviewed)

-LIC610 Emergency Disaster Plan (Reviewed)

-An updated copy of Administrator Certificate (s)

Exit interview conducted and a copy of this report provided to Latashia Perry, Licensee.