Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan, met with Executive Director Desiree Kitagawa for a One (1) Year Required - Infection Control visit for this facility. LPA explained the reason for the visit.

A tour of the physical plant was conducted at 10:43 AM and the following were noted:

There is only one entrance being utilized at the facility, the front main entrance door. There are required poster posted at the main door. Screening area is located immediately upon entrance. All visitors/resident and staff are required to sign. There is also a sign in sheet, hand sanitizer, gloves and masks available. LPA was screened upon entry. All staff were observed to be wearing mask upon entrance and during visit.

The facility had submitted and approved Mitigation plan.

There are hand sanitizing stations all over the facility. There are signs to wear a mask and other Covid 19 prevention protocol signs were posted outside the doors. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in common bathrooms, elevators and all over the common areas of the facility. The facility has a designated visitors' area in the front entrance and lobby. The facility has sufficient stock of PPE in the storage room.

The facility is fire cleared for One hundred six (106) non-ambulatory residents, forty (40) of which may be bedridden. Hospice waiver is approved for ten (10) residents.