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, 1 office, 2 bathrooms, kitchen with dinning area, living room and an attached garage.

COVID-19 Infection Control Practices (including signs) were observed.

PPE supplies were inspected. Additional PPE supplies are stored inside a large storage cabinet located in the living room.

Medications for (3) clients were reviewed (C-1 through C-3).

Per S-1, (3) clients have the COVID 19 vaccine and booster.

Per S-1, (7) staff have the COVID 19 vaccine and booster.

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

Bathrooms have hand washing soap and paper towels.

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.