Facility Evaluation Report

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced Required One (1) year Infection Control inspection to the facility. LPA met with Administrator Mary Ballard and explained the reason for the visit.

A tour of the physical plant was conducted at 1:40 pm and the following was noted:

There is only one entrance being utilized at the facility, there are required posters posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves, and masks are available. LPA was screened upon entry.

The facility had submitted and approved Mitigation Plan.

Signs to wear a mask and other COVID-19 prevention protocol signs were posted outside the door. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted throughout the facility. The facility has a designated visitors' area in the backyard. The facility has sufficient stock of PPE in the storage room.

The facility has four (4) bedrooms and three (3) bathrooms currently occupying five (05) residents. Two (02) rooms are shared rooms. One room is for staff.