Facility Evaluation Report

Licensing Program Analysts (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 baths, kitchen, dinning area, living room and attached garage.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this home, in all common rooms and hallways.

PPE supplies were inspected. Additional PPE supplies are stored inside the garage

Hygiene supplies were observed. Additional hygiene supplies are stored inside the garage.

Medications for (4) clients were reviewed (C-1 through C-4).

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

Bathrooms have hand washing soap and paper towels. Hand washing signs were also observed inside both bathrooms.

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 food supply is stored inside the garage.

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.