Facility Evaluation Report

Licensing Program Analyst (LPA) LaQueena Lacy arrived at the facility at 10:12am to conduct a One (1)

year Required Infection Control visit. LPA meet with the Administrator Monina Miller & Virginia Miller and explained the

A tour of the physical plant was conducted at 10:18am and the following was observed:

The facility has one main entrance being used, there are required Covid-19 prevention signage (hand

washing, coughing etiquette and physical distancing) posted. The PPE screening station is located at the

entrance of the facility and is equipped with sufficient PPE readily accessible with hand sanitizer, gloves,

mask and sign in sheet at the time of visit. The facility has sixteen (16) bedrooms which are designated for residents. Eleven (11) located in the front main house which is being occupied by three (3) out of ten (10) residents in care. The second house is located behind the main house and is occupied by seven (7) out of 10 residents in care. The third house is adjacent to the main house and is occupied by the licensee Virginia Miller and Monina Miller. The fourth house is located to the front left of the main house and is occupied by staff Eric Miller. The facility maintains a comfortable temperature of 75 degrees. Administrator Monina Miller, Virginia Miller and Eric Miller are the only live in staff during this visit.

The facility has an approved mitigation plan on file.

Kitchen: At 10:27am LPA observed the kitchen to be clean and an adequate supply of perishables and

non-perishable food located in the fridge, freezer, pantry, and deep freezer located in a room adjacent to the kitchen where the emergency food is also stored. Food is properly labeled and stored. Food storage and preparation areas are clean and inaccessible to pests. Trash cans observed to be with tight fitting lids.