Facility Evaluation Report

On 12/13/2021, Licensing Program Analysts (LPAs) Walton and Kaur arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. Facility has one central entry and exit point. LPAs introduced selves, stated the purpose of the visit and was granted entry to the facility by Caregiver. LPAs met with Administrator, Amabelle Bernales.

Facility tour conducted with Administrator. All pathways, entrances and exits were clear from obstructions. No fire clearance issues. LPAs observed signs promoting social distancing and cough/sneeze etiquette. Facility staff observed without facial coverings. LPAs toured the facility kitchen. LPAs observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. LPAs observed a 30 day supply of PPE and cleaning supplies. LPAs checked residents' medication and observed a 30 day supply.

There are 3 private rooms and 1 shared bedroom. Beds in the shared bedroom observed to be at least 6 feet apart. LPAs observed the window in bedroom 1 to be broken. Liquid soap and paper towels are available in the bathrooms. Hand-washing signs were not observed in resident bathrooms. LPAs observed black mold growing on the shower curtain in bathroom 1. Per Administrator and Facility staff, the facility is cleaned twice a week.

Resident and staff temperature checks are documented daily. LPAs reviewed resident records and observed that 5 out of 5 residents do not have updated emergency contact information. Staff records were reviewed for good health.