Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced Required - 1 Year Annual visit with the primary focus on Infection Control measures and using 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 was properly screened for COVID-19 symptoms, and temperature was checked. LPA Bunker met with Licensee/Administrator Angela Love 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 six (6) residents in placement. 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."

Ms. Love and LPA Bunker toured the facility, which is a single-story family home located in a residential neighborhood. The house consists of a living room, family room, dining room, kitchen, office, 5 bedrooms, 2 bathrooms, laundry room, detached garage, an indoor/outdoor activity area, and a shaded area furnished with outdoor patio furniture, including tables and chairs. Bedrooms #1 through #5 are designated as the resident's bedrooms.