Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPAs met with S-1 and explained the purpose of the visit.

This home consists of (3) bedrooms, (2) bath, living room, family/t.v. room, kitchen, dinning area and attached garage.

COVID-19 Infection Control Practices were observed at the entrance of this home and in all common rooms and hallways. Signs were posted throughout the facility.

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Bathrooms had hand washing signs, liquid soap and paper towels.

Medications for (5) clients were reviewed for Client #1 through Client #5 (C-1 through C-5).

Staff responsible for direct care and supervision were observed wearing masks.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed. Additional supply is stored inside the garage. Additional water supply was also observed.

Sufficient PPE supply observed. Additional supply is stored inside the garage.

Per S-1, (5) clients have both COVID-19 vaccines and booster.

Per S-1, COVID testing occurs every Tuesday.

Clients were socially distanced according to local public health guidelines.

Exit interview conducted, a copy of this report and Appeal Rights were provided to S-1