Facility Evaluation Report

On 11/29/2022 at 11:18 a.m. Licensing Program Analyst (LPA) Evelin Rios arrived at the facility mentioned above to conduct a Required Annual/Infection Control inspection. LPA was greeted by Staff Vincent Igid who was wearing a mask and granted access. LPA asked Vincent to call administrator Fabiola Igid. Fabiola will not be able meet us at the facility because she is with a resident at their doctor's appointment. LPA explained the reason for the visit over the phone to Fabiola. Fabiola designated Vincent to sign for this report. LPA reviewed the Mitigation Plan approved 03/06/2021. The inspection tool was used to complete the visit.

At 11:21 a.m. LPA began a physical plant tour of the facility and following was observed:

Dining / Living Area: The dining and living area were well lit, clean and clear of clutter. Furniture appeared clean and in good repair. LPA observed proper Covid-19 signs posted through out the facility. LPA observed the thermostat at a comfortable temperature of 75°F

Tv Area: In the TV area LPA observed it to be clean and clear of clutter. Furniture appeared clean and in good repair. A fireplace located in the TV area is not in use.

Kitchen: LPA observed the kitchen to be clean and clear of clutter. All appliances were functioning. LPA observed two (2) day perishable and seven (7) day non-perishable foods. Cleaning solutions are locked under the sink. The fire extinguisher one (1) of two (2) was observed in the kitchen and was last serviced on 07/15/2022. Fire extinguisher two (2) of two (2) was observed in the hallway with service date 07/15/2022.

Bedrooms: There are five (5) bedrooms designated for resident use. Five (5) out five (5) resident rooms are furnished with required lighting, dresser, chair, bed, and linens. There was an extra supply of linens in a hallway closet. One (1) of five (5) bedrooms is shared by a couple.