Facility Evaluation Report

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

The facility had a universal entrance screening area including a screening sheet, thermometer, and hand sanitizer. A temperature check log for staff and residents was maintained daily.

COVID-19 signage was placed in several areas including entrance and common areas.

Facility maintained a 30-day supply of PPE.

Staff wore face masks throughout their shift and furniture was placed to encourage physical distancing.

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

Cleaning solutions and sharps were locked and inaccessible.

Water temperature was measured and were within required 105-120 degrees F.

All resident rooms contained required furniture including bed, dresser, night stand, lamp and chair.

Medications were locked and centrally stored and facility maintained a 30-day supply of medications.

Smoke detectors/carbon monoxide detectors were present and operable.

Indoor/outdoor passageways were free from obstruction, clean, and in good repair.

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

Client files were inspected and emergency contact information and health screenings were up to date for all clients.

Staff files were inspected and contained the required health screenings, criminal record clearances, and trainings.

Administrator certificate was inspected and had expired on 7/2021.

Pursuant to Title 22, a deficiency was cited on the attached 809D. An exit interview was conducted and a copy of this report and appeal rights were provided to the lead caregiver.