Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps arrived at the facility for an unannounced one (1) year Required visit for this facility.

LPA arrived at 1:45 pm and was greeted by caregiver Gladys Gomez. Two (2) clients were observed in the dining room doing activities, and the rest of the clients were observed to be in their rooms resting or watching TV. LPA spoke to Licensee over phone, who stated he was at a doctor appointment and would be able to arrive in 45 minutes. LPA informed the Licensee of the purpose of the visit and informed him the inspection would begin with the caregiver. The Licensee stated the caregiver could sign the report if he did not make it to the facility before the inspection was completed.

A tour of the physical plant was conducted with caregiver Gladys at 2:10 pm. The facility has four (4) bedrooms and two and a half (2 1/2) bathrooms currently occupying four (4) clients. One (1) bathroom and bathroom is designated for staff use only. The facility is Fire Cleared for four (4) ambulatory.

Infection control: LPA reviewed facility mitigation plan (approved on 03/13/21) to make sure licensee was following current infection control recommendations. Upon arrival LPA was screened by the caregiver and asked all infection control questions. LPA was signed-in and sanitizer was available.

LPA observed rooms to have the appropriate bedding. There is a night stand and sufficient lighting for each client.

At 2:25pm LPA observed all bathrooms to have the appropriated wash your hands signs posted. Hot water was tested and measured within regulation at 105.0 degrees F. CONTINUED...