Facility Evaluation Report

A Required One (1) year Annual- Infection Control visit was conducted today by Licensing Program Analyst (LPA) Michael Cava. LPA met with the administrator, Rosana Tomaneng and stated the purpose of the visit. The facility has a census of three (3), but all residents were out either at work or on their own activity.

The tour of the physical plant was conducted at 9:00am and the following were noted:

The front/main door is the only entrance being utilized for entry. There is a sign on the door that everyone entering at the facility must wear a mask and must be screened. The screening area is located near the entrance. Sign in sheet, hand sanitizer, gloves and masks are available. LPA Cava was screened by staff upon entry. All staff were observed to be wearing a mask. Including the administrator, there were two (2) staff on duty.

The facility submitted a Mitigation Plan.

Signs to wear a mask and other COVID 19 prevention protocol signs were posted on the walls. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. All trash cans were observed to be with covers. The facility has a sufficient supply of PPE in the storage room.

Resident room s: Facility has six (6) bedrooms. Two (2) rooms are for staff use. Four (4) private rooms are designated for client use. All four met regulation. LPA observed rooms to have appropriate bedding sheets, pillowcase, mattress pad, and blanket which are in good condition. There is at least one chair, night stand and sufficient lighting for each client. The mattresses and bedsprings were also checked for condition.