Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan, met with Administrator Mary Jane Garner for a One (1) year required visit for this facility.

A tour of the physical plant was conducted at 12:30 PM and the following was noted:

There is only one entrance being utilized at the facility and must pass through a gate before reaching the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan. 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 the bathroom and all over the facility. The facility has a designated visitors' area at the front yard inside the gate. The facility has sufficient stock of PPE in the storage room.

The facility has five (5) bedrooms and three (3) bathrooms currently occupying four (4) residents. One (1) bedroom and one (1) bathroom is designated for staff use. The facility is fire cleared for six (6) non-ambulatory residents, one (1) of which maybe bedridden. Hospice waiver for one (1) resident.

Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings and doors were checked, the following was noted:

Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 75°F. Dual smoke and carbon monoxide detectors were tested and observed to be operational. There is a fire extinguisher located in the kitchen and was observed to be full and last inspected on 05/01/23. The front yard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water in the facility.