Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus on the Infection Control Domain. LPA Chan arrived unannounced and met with Administrator Robert Risinger. The facility is licensed for 6 non-ambulatory adults, ages 18 through 59, of which 1 may be bedridden. The bedridden room is located in room #5. There is currently one client residing at the home.

The facility consists of 5 bedrooms, 4 1/2 bathrooms, living room, dining room, kitchen, laundry area, and an attached garage. The backyard has a shaded area for client use. The facility previously submitted a mitigation plan in which they are still following.

The inspection consisted of the following:

There is one entry point for visitors. Visitors are screened for COVID-19 symptoms and temperature taken.

COVID-19 signage are posted throughout the home.

There are sufficient supplies of 2-day perishable and a week of non-perishable observed.

Each client bedroom had the required furniture and well maintained. The bathrooms have paper towels and soap.

PPE supplies for at least 30-days are stored in the garage.

Sharps, knives, and cleaning solutions are locked.

Medications are locked and centrally stored in the kitchen area.

Emergency Contact information are posted on the bulletin board.

No deficiencies issued today. An exit interview was conducted and a copy of this report was given to the Administrator.