Facility Evaluation Report

LPA Spaeth conducted an unannounced visit and was greeted by the caregiver and a resident. LPA stated the purpose of the visit was to conduct a case management visit. LPA observed two residents in the facility and two residents had left earlier this morning for work LPA's temperature was recorded. LPA spoke to the two residents and also toured the facility. LPA and Caregiver began the tour at 8:00 am until 8:20 am.

Living room/Kitchen/Dining Room - LPA observed the living room, kitchen, and dining room are all combined. . LPA observed the living room contains comfortable seatin. The kitchen was clean and LPA observed fresh fruit on the counter. The facility contained a two-day supply of perishable foods and a 7 day supply of non-perishable foods. The knives, laundry soap, and cleaning supplies were safely locked under the kitchen cabinet. LPA observed the staff office and observed the medications were locked in a cabinet.

Resident bedrooms. - LPA observed the three resident rooms which contained bed, linens, night stand, lamp, and chest of drawers. The resident bathroom was clean and in working condition.

Upon entering the facility, LPA observed the caregiver was not wearing a mask. LPA reminded caregiver that staff are still required to wear a mask. Based upon LPA's observation, a deficiency is cited on LIC 809-D.

Exit interview conducted, appeal rights discussed, and a copy of the report was given to the caregiver.