Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced Annual Required 1 Year Visit with the primary focus on infection control measures and the use of the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the evaluation, the facility is clear of COVID-19 infection. LPA Bunker met with Licensee/Administrator Henry Wallace and explained the purpose of today's annual inspection. LPA verified that the facility has an approved Mitigation Plan Report and Infection Control Report. There are currently no residents in placement, and the facility’s annual fees are up to date.

The following 12 Domains will be observed and reviewed: Infection Control, Operational Requirements, Physical Plant & Environmental Safety, Staffing, Personnel Records-Training/Staff Training, Resident Rights-Information, Planned Activities, Food Service, Incidental Medical and Dental, Resident Records/Incident Reports, Disaster Preparedness, and Resident with Special Health Needs. "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."

LPA Bunker and Licensee/Administrator conducted a tour of the facility, which is a single-story family home located in a residential neighborhood. The home includes a living room, dining room, kitchen, three bedrooms, one bathroom, a laundry room, a detached garage, and an indoor/outdoor activity area. Bedrooms #1-3 are designated as the resident's bedrooms. There is a shaded outdoor space furnished with patio furniture, including tables and chairs.