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 S-1 and explained the purpose of today's visit. Administrator arrived at approximately 9:30 A.M..

This is a single home with (3) bedrooms, (1) bathroom, kitchen, dinning area, living room and an attached garage.

COVID-19 Infection Control Practices were observed at the entrance of this facility and throughout the facility. COVID signs were throughout the facility.

Bathrooms had hand soap and hand sanitizer.

PPE and hygiene supplies observed. Additional supplies are stored inside the garage.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. Additional food supplies are stored inside the garage.

Staff responsible for direct care and supervision will wear masks.

Clients were be socially distanced according to local public health guidelines.

Medication reviewed for (6) Clients (Client #1 through Client #6).

Per S-2, (6) clients have both COVID vaccines and have the booster.

Per S-2, (7) staff have both COVID vaccines and have the booster.

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