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 discussed the purpose of today's visit.

This facility consists of (4) bedrooms/(1) of which is used as an office, (3) bathrooms, living room, kitchen/dinning area, den and 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 observed.

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

Restrooms have hand soap and paper towels. Hand sanitizers observed in common areas throughout this facility.

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

Per S-1, all (4) clients have both vaccines and 1st booster.

Per S-1, there are (7) staff members have both vaccines and 1st booster.

Medication reviewed for (4) Clients (Client #1 through Client #4).

Staff responsible for direct care and supervision will wear masks.

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

LPA discussed the infection control plan which will be submitted to CDSS by 06/30/2022. Exit interview conducted, a copy of this report and Appeal Rights were provided to S-1. LPA was having technical difficulties during this visit.