Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps met with administrator David Taylor for an unannounced one (1) year Required visit for this facility.

LPA arrived at 10:35 am and was greeted by a caregiver. One (1) resident was observed in the living room watching TV. The rest of the residents were observed to be in their room sleeping, watching TV and/or resting. The Administrator arrived at 11:05 am. LPA informed the Administrator of the purpose of the visit.

Infection control: LPA previously reviewed the facility mitigation plan (approved on 03/ 1 8/21) to make sure the licensee was following current infection control recommendations. Upon arrival LPA was screened by the caregiver and asked all infection control questions. LPA was asked to sign-in and sanitize r was available .

A tour of the physical plant was conducted with Administrator at 11:10 am. The facility has four (4) bedrooms and two (2) bathrooms currently occupying six (6) residents. One (1) bedroom is designated for staff use only. The facility is Fire Cleared for four (4) ambulatory, two (2) non-ambulatory, and a hospice waiver for one (1). At this time the facility has no residents on hospice.

LPA conducted tour of the kitchen around 11:12 am observed there to be sufficient stock of two-day perishables and seven-day non-perishables foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas care clean and inaccessible to pests. LPA observed all knives and sharp object being locked and inaccessible to residents in care. The Medication cabinet was located in kitchen and was observed to be locked and inaccessible to residents in care.