Facility Evaluation Report

Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Staff Bobbie Arnold and discussed the purpose of the visit. LPA and Staff Bobbie Arnold began the tour at the front entrance of the facility. LPA contacted Licensee via telephone who advised the facility does not have an Administrator at this time due to the Administrator's certificate expiring 3/22. Facility does not have a mitigation plan and Licensee agrees to submit an LIC 808 to CCLD.

Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/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 observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed to be on the garage floor not locked and accessible to residents in care. Facility does not have personal protective equipment at the facility. Staff advised the Licensee has all of the PPE off site.

Resident’s files have updated emergency contact information.

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