Facility Evaluation Report

On 02/21/2023 at 9:39 a.m. Licensing Program Analyst (LPA), Evelin Rios, conducted an unannounced annual inspection / infection control visit at the facility mentioned above. LPA was greeted by staff member (S1), who granted access to the facility. Administrator's assistant Karla Plata arrived at 9:50 a.m. and LPA explained the reason for the visit. Administrator Maria Rowena Cruz could not attend todays visit and designated Karla to sign today's report.

At 9:50 a.m. physical tour was conducted with Karla and LPA and they observed the following:

Infection control: LPA reviewed the facility mitigation plan approved on 04/11/2021 and noted infection control plan was filed 06/17/2022. Upon arrival, LPA was screened and temperature was taken by S1. When Karla arrived she directed LPA to sign in. Proper infection control signs were observed inside along the hallway. Hand sanitizer, masks and gloves were observed in a cart upon entry. Karla stated they have sufficient PPE supplies for residents and staff.

Bedrooms: There are six (6) total bedrooms four (4) are designated for residents use and have sufficient lighting. All residents' bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational.

Bathrooms: There are two (2) bathroom available for resident use. LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet paper, soap and paper towels. LPA observed appropriate hand washing signs posted in each bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination. At 10:25 a.m. LPA observed hot water temperature at 118.7 degrees Fahrenheit.