Facility Evaluation Report

Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Administrator Honesto Fernandez and discussed the purpose of the visit. LPA and Administrator Honesto Fernandez began the tour at the front entrance/office of the facility. Facility has a mitigation plan however needs to submit plan on the LIC 808 by a week from today's date.

Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed to be locked in the garage. LPA observed the following personal protective equipment in office; face shield, gloves, and masks. Facility has not trained staff on infection control. LPA observed all facility staff wearing masks.

Resident’s files have updated emergency contact information.

Exit interview was conducted and a copy of this report was provided