Facility Evaluation Report

Licensing Program Analysts (LPA) S Vaid conducted the required annual inspection. LPA met with Grace Obar who allowed entry into the facility. Licensee / Administrator Rona Lomeda was notified and arrived shortly after and discussed the purpose of today’s visit. LPA toured the facility and did not observe any health and safety issues.

The facility is licensed to serve the elderly ages 60 and above. Fire clearance approved for six (6) non-ambulatory and one (1) bedridden in bedroom #5. Hospice waiver approved for six (6). The facility is a single-story building located in a residential area with five (5) resident bedrooms, two (2) resident bathrooms, kitchen, dining room, living room, front yard, backyard, and attached garage without entry from main house. Currently there are four (4) non-ambulatory residents currently residing, zero (0) residents are currently bedridden.

LPA utilized the Compliance and Regulatory Enforcement tools for the visit today and observed the following:

1.Infection Control: There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place.

2.Operational Requirements: The fire clearance is approved for six (6) non ambulatory and hospice waivers for six (6). There are currently four (4) residents of which four (4) are non-ambulatory. Staff are adhering to operational requirements.