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 administrator Adedolapo Olusoji and discussed the purpose of today's visit. This single-story home contains four (4) bedrooms, two (2) bathrooms, an office, a living room, kitchen, dining room, backyard, and attached garage.

The facility had a universal entrance screening area including a sign-in 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 did not maintain a 30-day supply of PPE including N-95, gowns, and face shields.

Staff wore face masks throughout their shift and furniture was spaced for physical distancing.

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

Cleaning solutions and sharps were locked and inaccessible.

Water temperature was measured and were not within required 105-120 degrees F. Bathroom temperatures were measured at 129.3 and 127.5, and kitchen was measured at 129.7.

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

Medications were locked and centrally stored. However, medications were not given as prescribed due to missing medications.

Smoke detectors/carbon monoxide detectors were present and operable.

Indoor/outdoor passageways were free from obstruction.

The common bathroom was in disrepair due to toilet and shower not in working order.

A fire extinguisher was observed to be fully charged and recently serviced.

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 expires on 12/2022.

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