Facility Evaluation Report

Licensing Program Analyst (LPA) Angel Ascencio arrived at the facility unannounced to conduct a required Annual visit. This annual had a specific emphasis on infection control practices and procedures. LPA Ascencio met with Administrators Zenaida and Ricardo Velasco at 1:00 p.m. and explained the reason for the visit. Administrator mentioned to LPA that the facility does not have any residents at this time. Administrator was advised to call the Department once the facility admits their first resident. LPA Ascencio toured the physical plant areas inside and outside, with Administrator at 1:05 p.m.

BEDROOMS: There are (4) four bedrooms designated for resident use. Bedroom #2 and Bedroom #4 have a direct exit to the exterior. The facility is capable of furnishing each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. Bedroom #3 leads to a hallway, which allows for access to Bedroom #5 and Bedroom #6; however, those two rooms designated for staff. There is an exterior door that leads to Bedroom #5 and Bedroom #6. Staff are aware that once they have residents in Bedroom #3, staff would need to enter their rooms through the exterior door.

RESTROOMS: There are (2) bathrooms designated for resident use. There is a bathroom designated for staff use only. Bathrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA advised the Administrators to ensure that bathrooms were stocked with paper towels and hand-washing signs prior to allowing resident admissions. Hot water temperature was tested throughout the home and was within normal ranges between 105.0 F and 120.0 F.

COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and

good condition. At the time of the visit, common seating area and dining room furniture was

observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social