Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted unannounced visit for the purpose of 1 year required infection control inspection. LPA was greeted at the door by caregiver Susan Robles and granted entry. Administrator Maria Pliss arrived a short time later. LPA discussed purpose of visit. LPA was informed by caregiver that there are currently four (4) clients residing at this facility.

LPA accompanied by caregiver Susan began the tour of the inside and outside of facility which is a one story home. The home consists of four (4) client bedrooms, one (1) staff room, two (2) bathrooms, a living room, dining room, kitchen, patio and a large backyard. The washer and dryer unit is located adjacent to the kitchen area. There is an unattached garage which is locked and not accessibility to clients. Fire clearance is maintained in conformity with State Fire Marshall regulations. There are no bodies of water of firearms at this location. Last fire drill was on 5/12/2022 and Administrator certificate expires on 12/17/2022

· COVID-19 signs are posted at the entrance. Visitors are screened in the main entrance and a log is kept.

· Infection control signs and other COVID-19 signs are posted throughout the facility in the bathrooms, kitchen, and hallway to promote handwashing, cough/sneeze etiquette, and physical distancing.

· Facility does not have a designated isolation room as all the clients have private rooms

· Four client rooms, common areas, bathrooms, and outdoor physical plant was inspected.

· Client rooms were not equipped with alcohol-based hand sanitizer but available throughout facility.

· Four (4) centrally stored client medication records were reviewed.

· Staff responsible for direct care and supervision were observed wearing masks.

· Clients were not observed wearing masks but adhering to public health social distance guidelines.

· Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.