Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1-year annual visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the assessment, the facility is clear of COVID-19 infection. LPA was properly screened for COVID-19 symptoms and LPA temperature was checked. LPA Bunker met with Licensee/Administrator Shirley A. Jones and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report and infection control plan. There are currently ten (10), Adult Residential Care Facility (ARF) Mentally Disabled residents in placement.

The following 12 Domains will be observed and reviewed: Infection Control, Physical Plant & Environmental Safety, Operational Requirements, Staffing, Personnel Records-Training, Client Rights-Information, Client Records-Incident Reports, Food Service, Health-Related Services, Incidental Medical Services, Disaster Preparedness, and Emergency Intervention. "LPA Bunker will be using this tool and methods that have been developed to improve the efficiency and accuracy of the Department of Social Services' facility inspections."

The facility is a single-story-family home located in a residential neighborhood. Licensee Ms. Jones and LPA Bunker toured the facility which consisted of the following: Living room, office, 2 kitchens, dining area, 5 bedrooms, 2 bathrooms, freezer/storage room, laundry area in the garage, shaded area, indoor/outdoor activity areas, and a detached garage. The front and back yard landscape is in good condition at the time of visit.