Facility Evaluation Report

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

This home consists of the following: (4) private client bedrooms (each client has their own private bedroom), (2) full bathrooms, living room, kitchen, dinning area, laundry room and has an attached garage.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and throughout the facility. Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were also observed.

PPE supplies observed (stored inside the garage).

Incontinence care supplies observed (stored inside the garage).

Hygiene supplies observed (stored inside the garage).

Restrooms have hand soap, hand sanitizer and hand paper towels. Hand washing signs posted.

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

Per Administrator, all (3) clients are fully vaccinated including (2) boosters and have the flu vaccine.

Per Administrator, all staff are fully vaccinated and have boosters.

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 Jorge Romero