Facility Evaluation Report

On 04/18/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with administrator. LPA met with Lancia Griffin, Caregiver. LPA met with Licensee Olivia Oblea conduct tour with LPA. Licensee stated to LPA caregiver is not fingerprinted cleared. LPA observed caregiver providing care for residents. All five residents were present during the inspection.

Upon entry facility staffs were observed with no facial covering. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to residents and visitors. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. LPA observed social distancing posting. Cough etiquette posting was not observed.

LPA observed small amount of PPE supplies in facility. 30 days PPE supplies storage in a central location. Food supply was checked and appeared to be an adequate supply. At 10:30 a.m. LPA and licensee observed cleaning chemicals unlocked under kitchen sink. LPA and licensee observed cleaning supplies unlocked under kitchen sink. At 10:40 a.m. LPA and licensee observed knives in unlocked drawer. LPA and Licensee observed fire extinguisher served date: 04/04/21. At 10:50 a.m. LPA checked residents’ medications. LPA and Licensee observed medications unlock in hall cabinets.

All resident’s room toured and observed to be adequately furnished and lit. LPA observed 5 bedrooms that are single occupant. All bathrooms are observed with securely fastened grab bars and non-skid mat. All bathrooms observed trash bin with lid. Hand washing posting were not observed by bathroom sinks.

The exterior tour was conducted. Side gate was self-closing and self-latching. Staff records were reviewed for good health and infection control training. All resident records reviewed to have updated emergency contact information. Continue on Lic 809C.