Facility Evaluation Report

Licensing Program Analyst (LPA) Spencer conducted an unannounced annual inspection focusing on the Infection Control Domain. LPA Spencer was greeted by administrator Brittany Jones and discussed the purpose of today's visit. This single-story home contains four (4) bedrooms, two (2) bathrooms, a living room, kitchen, dining area, backyard, and detached garage.

The facility had a universal entrance screening area including a thermometer, PPE supplies, screening logs, and sign-in sheet.

COVID-19 signage was placed in several areas of the facility.

Facility maintained a 30-day supply of PPE located in the supply closet and garage.

There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods.

Cleaning solutions and sharps were locked and inaccessible.

Water temperature was measured in kitchen and bathrooms. Bathroom #2 water temperature read 121.4 degrees F. Staff immediately adjusted water meter and all areas measured within 105-120 F.

Each room contained required furniture including bed, dresser, night stand, lamp and chair.

Bathrooms contained hygiene supplies including liquid soap, paper towels, and toilet paper.

Medications were locked, centrally stored, and given as prescribed. Medications were reviewed for all residents and facility maintained a 30-day supply of medications.

Staff wore face masks throughout their shift.

Furniture and group activities were spaced to encourage physical distancing.

Smoke detectors/carbon monoxide detectors were present and operable.

A fire extinguisher was observed to be fully charged and last serviced January 2021.

Client files were inspected and emergency contact information was up to date.

Four (4) staff files were inspected and contained required health screenings, criminal record clearances, and training certificates. Administrator certificate expires 8/2022.

There were no deficiencies cited at this time. Technical violation issued on separate LIC9102 form. An exit interview was conducted and a copy of this report were provided to the administrator.