Facility Evaluation Report

On 10/10/2022, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct an infection control annual inspection. LPA explained reason for the visit, but the Administrator was sick so LPA met with Staff Member Rico Paguio, who accompanied LPA to tour the facility inside and out.

The administrator is the designated infection control leader. The staff had not been trained on, nor could they find a copy of the Infection Control Plan the Licensee had sent to the Department on 08/05/2022. LPA observed that staff followed only some Covid-19 infection control guidelines. They were not checking or recording temperatures of visitors or staff upon entry. They had few PPE supplies. No masking or Covid-19 signs were posted.

The facility was clean, well maintained, and no obstructions. There was a sufficient supply of perishable and nonperishable food on hand, though the refrigerated and frozen food had no date when opened. The fire extinguisher has been serviced within the past 12 months. The carbon monoxide and smoke detectors were fully functional. The temperature inside of the facility was 71.6 and the hot water was 118 degrees. A certified administrator is on site more than the minimum of 20 hours a week to oversee proper business operation.

The facility was cited for 2 A-Type and 6 B-Type deficiencies (refer to LIC809-D forms), as well as 2 civil penalties for repeat violations.

By 10/17/2022, Licensee will send updated forms to LPA:

· LIC308 - Designation of Facility Responsibility

Exit interview conducted, copy of Appeal Rights, and a copy of this report provided via email.