Facility Evaluation Report

LPA Spaeth arrived to the facility and was greeted by Administrator. LPA observed the COVID signs on the front door. LPA stated the purpose of the visit was to conduct a case management visit regarding incident report received by CCL. LPA observed two residents (R1 and R2) were participating in activities. LPA was advised R3 was away from the facility. LPA's temperature was recorded and LPA was requested to sign in at the sign in station.

LPA observed the facility was well stocked with a seven day supply of canned goods and a two day supply of fresh vegetables. The knives and medications were locked in a file cabinet in the dining room. LPA observed the three bathrooms contained hand soap, paper towels, and a trash can. LPA observed two residents' rooms which contained bed, linens, night stand, and lamp.

LPA observed two staff members were not wearing masks. Based upon LPA's observation, the following deficiency was cited. See attached 809-D for further details