Facility Evaluation Report

Licensing Program Analyst (LPA) A. Walton arrived unannounced at the above facility LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Licensee, Helen Houck who arrived a short time later. Upon entry to the facility, LPA observed staff not wearing facial coverings, staff donned a surgical face mask after LPA entered.

A tour of the facility was conducted. COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point.

Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Bathrooms have trash cans with lid. Hand washing posters were observed by the bathroom sink. Bedrooms are single occupant.

LPA checked residents’ locked medications and observed a 30-day supply. Food supply was checked and there appeared to be an adequate supply. Cleaning and PPE supplies were checked. Staff records were reviewed for good health and infection control training. Residents wear masks when away from the community. 3 out of 4 Resident files do not have updated emergency contact information.

No deficiencies were observed. Exit interview was conducted. Licensee was informed that as a COVID-19 precautionary measure, this report will be provided via email and an electronic read receipt confirms receiving this document. Facility Representative signature on file.