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 Connie Mitchell and discussed the purpose of today's visit.

This home consists of: (4) bedrooms, (2) bathroom, office, living room, kitchen with dinning area and an attached garage.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and the dinning area.

Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were observed.

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

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

Bathrooms have hand soap, paper towels and hand washing signs.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. An additional refrigerator and canned goods were observed inside the garage.

Medication reviewed for Client #1 through Client #4 (C-1 through C-4).

Staff responsible for direct care and supervision will continue wearing masks.

Exit interview conducted, a copy of this report and Appeal Rights were provided to Connie Mitchell