Facility Evaluation Report

Licensing Program Analyst (LPA) Darius Williams conducted an Annual Inspection on this date. LPA was met by staff and discussed the purpose of the visit. Administrator Gonzalo Cruz, arrived at a later time and conducted a tour with the LPA.

Temperature check, masks, and disinfection station were observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed behind a locked cabinet in the garage. LPA observed the following personal protective equipment in a storage cabinet in garage; gown, face shield, gloves, and masks.LPA observed all facility staff wearing masks. Staff retrieved training regarding Covid-19 and general infection control. Four of four resident’s files have updated emergency contact information.

LPA Williams requested the following documents be sent to the Department by 11/23/2022 ; personnel report (LIC 500), designation of facility responsibility (LIC 308), and Administrator certificate.

An cxit interview was conducted and a copy of this report was provided.