Facility Evaluation Report

On 10/21/2021, Licensing Program Analyst (LPA) A. Walton arrived unannounced at the above facility to conduct an Annual Inspection. Facility has one central entry and exit point. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. Facility staff contacted Licensee, LPA received verbal permission from Licensee to meet with Caregiver. LPA met with Caregiver, Joseph Rafanan. Upon entry, LPA observed a visitor log-in/temperature check. Facility staff observed to be wearing facial coverings.

There are three residents present during this inspection.

Facility tour conducted with Caregiver. All pathways, entrances and exits were clear from obstructions. No fire clearance issues. LPA observed signs promoting hand-washing, social distancing, and cough/sneeze etiquette. LPA checked residents' medication and observed a 30 day supply. LPA toured the facility kitchen. LPA observed a 7-day supply of perishable foods and a 2-day supply of perishable foods. LPA observed a 30 day supply of PPE and cleaning supplies.

Facility has two private rooms and one shared room. Beds in the shared room were observed to be at least 6 feet apart. Facility bathrooms were stocked with paper towels and liquid soap. Hand-washing signs observed in resident bathrooms. Resident temperature checks are documented daily. Resident records have updated emergency contact information. Facility staff records reviewed for good health and infection control training.