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 Kathy Ellet and explained the purpose of the visit. Administrator Lester Ellett arrived shortly after. There is one (1) level 3 ambulatory developmentally disabled client in the home. The facility is a single story home licensed for 4 ambulatory clients located in a residential neighborhood. It consists of 3 client bedrooms, 1 staff bedroom, 3 bathrooms, dining room, kitchen, living room, den, outdoor patio and detached garage. The last fire drill was conducted on 10/3/2021. Administrator certificate expires March 24, 2023.

The interior and exterior physical plant was inspected.

COVID-19 Infection Control Practices and signs were observed in the entrance, common areas, hallways, bathrooms and client rooms.

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing. Furniture was observed to be at least 6 feet apart.

Facility has two (2) designated isolation rooms.

One (1) centrally stored client medication record was reviewed.

Client and staff were observed wearing a masks.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

A posted Emergency Disaster Plan was observed.

Sufficient supply of Personal Protective Equipment (PPEs) was observed.

Staff and resident files were not reviewed during today's visit.

Exit interview was conducted with Administrator Lester Ellett. A copy of the report was provided.