Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced annual inspection. LPA was allowed entry by S-1.

There are (3) clients residing at this home. This single story home consists of (3) bedrooms, 2 bathrooms, living room, kitchen, dinning area and attached garage. Annual Licensing fees are current.

Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were observed.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and throughout the facility.

PPE and hygiene supplies observed. These items are stored inside the office.

Restrooms have hand soap and hand sanitizer.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed.

Per Administrator, all (3) clients are fully vaccinated and have their booster.

Per Administrator, all staff are fully vaccinated.

Medication reviewed for (3) Clients (Client #1 through Client #3).

Staff responsible for direct care and supervision will wear masks.

Clients were be socially distanced according to local public health guidelines.

Exit interview conducted, a copy of this report and Appeal Rights were provided to Facility Administrator.