Facility Evaluation Report

At approximately 10:30AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-year required Annual Visit and met with Administrator, Jolly Carungcong. The inspection is focused on the Infection Control procedures and practices of this facility.

Upon arrival at the facility, LPA had their temperature checked and logged. LPA did not answer a COVID-19 Questionnaire. Per conversation with Administrator, Facility stopped using the questionnaire in February 2022. LPA and Administrator discussed the importance of having the questionnaire available to visitors in the event a COVID outbreak occurs.

LPA conducted a walk-through of the facility and observed the following: COVID-19 signs were observed at the entry way and throughout the facility. Hand-washing signs were observed in the public bathrooms and at sinks. Hand Sanitizer was readily available for use throughout the facility. Toxins and detergents were secured and inaccessible to residents. Medications were located in the medication room that was locked and inaccessible to residents. All staff present were observed to be wearing a mask. The facility was found to be clean and at a comfortable temperature with all exits free from obstruction.

LPA and Administrator discussed facility's plan for staffing if a shortage occurred.

Facility has a cleaning and disinfecting schedule that occurs two to three times per day. Facility has at least a 30-day supply of PPE and medication for residents. Staff and residents are screened daily for COVID-19 symptoms and it is logged into facility binders.

LPA and Administrator discussed PIN-22-13-ASC regarding Infection Control Plans.