Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with staff Norma Morgan and explained the purpose of the visit. There are four (4) ambulatory level 4i developmentally disabled clients in the home. The facility is a single story home located in a residential neighborhood. It consists of 3 client bedrooms, 2 bathrooms, dining room/family room, kitchen, living room, outdoor patio, and detached garage. The last fire/emergency drill was conducted on 7/12/2022. Administrator certificate expires 12/1/2022.

The interior and exterior physical plant was inspected. The facility is equipped with a fire pull alarm system. Smoke and carbon monoxide detectors were tested and operational.

COVID-19 Infection Control Practices and signs that promote hand washing, cough/sneeze etiquette, and physical distancing were observed in the entrance, common areas, hallways, bathrooms and client rooms. There is a screening station at the entrance of the facility to screen visitors.

Each client room is designated as a COVID-19 isolation room if needed.

A posted Emergency Disaster Plan was not observed.

Four (4) centrally stored client medication records were reviewed. Medications are documented properly and given as prescribed.

Staff were observed wearing mask. Clients do not wear masks due to disability exemption.

The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food.

Water temperature was within normal limits 105 degrees Fahrenheit (40.5 degrees C) and not more than 120 degrees Fahrenheit (48.8 degrees C).

Facility has an adequate 30-day+ supply of Personal Protective Equipment (PPEs).

The facility submitted a COVID-19 Mitigation Plan and Infection Control Plan.

Discarded gardening and grilling materials (sharp cleaning tools) were observed in the side yard. See 809D.

Exit interview was conducted with staff Norma Morgan A copy of the report and appeal rights will be emailed due to document printing problems.