Facility Evaluation Report

Licensing Program Analyst (LPA) Vaid conducted the required annual inspection. LPA arrived unannounced and met with Staff, Angel Lisa Ayento, who allowed entry. The purpose for the visit was explained.

The facility is licensed for residents aged 60 and over. The fire clearance is approved for (5) non-ambulatory residents in rooms #1, 2, 4, and 5. Bedroom 3 is approved for (1) bedridden. There is a hospice waiver approved for 6 residents.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents and medications. Disposals of trash are done immediately after changing a resident. Staff are still cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan posted by the entrance.

Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. There are currently 5 non-ambulatory residents residing at the facility. Bedroom #3 is the designated room for (1) bedridden resident only. The facility has enough for liability insurance covering injuries to residents and guest.

Physical Plant & Environment Safety: There are 5 bedrooms, 2 bathrooms, living room, dining room, kitchen, and an attached garage. The garage has an additional room allotted for a live-in staff room. Facility has operable smoke and carbon monoxide combo detectors located in each room and hallway. Knives, cleaning solutions, and disinfectants are locked in the cabinets. LPA measured the hot water temperature in the bathrooms, hot water temperature in the bathrooms were measured between 105-120 degrees F. CONTINUED 0N 809C............