Facility Evaluation Report

Licensing Program Analyst (LPA) Darius Wiliams conducted an unannounced Annual Inspection visit. LPA Williams met with Manager, Tori Morgan, and discussed the purpose of the visit.

LPA Williams toured the facility with the Manager.

LPA Williams observed a visitor/temperature log, masks, and disinfection station at the front entrance. Facility has one entry and exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA Williams observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies and medication were observed behind a locked cabinet door. LPA Williams observed the following personal protective equipment in storage; gowns, gloves, and masks.

LPA Williams observed staff training records regarding Covid-19 mitigation and infection control. LPA Williams observed all facility staff wearing masks.

Manager agreed to fax copies of all 3 residents Identification and Emergency Information form (LIC 601) to LPA Williams by 4:00 pm on Friday, 8/27/2021.

Exit interview was conducted and a copy of this report was provided.