Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with House Manager Stacy Lopez and explained the purpose of the visit. Administrator Linda Morales arrived shortly after. There are 6 residents 60 and older of which 3 are ambulatory and 3 non ambulatory. Facility is a single story home located in a residential area consisting of 5 client rooms, 3 bathrooms, living room, dining room, backyard patio area, and detached garage. The last fire drill was completed on December 10, 2021. Administrator certificate expires January 03, 2023.

· 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 hand washing, cough/sneeze etiquette, and physical distancing.

· Facility has ability to designate isolation room.

· Five (5) client rooms, common areas, bathrooms, and outdoor physical plant was inspected.

· All client rooms were equipped with alcohol-based hand sanitizer.

· 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 food for 2 days & non-perishable foods for 7 days were observed.

· A posted Emergency Disaster Plan was observed.

· Staff and resident files were not reviewed during today's visit.

Exit interview was conducted with Administrator Linda Morales.. A copy of the report was provided.