Facility Evaluation Report

Licensing Program Analyst (LPA) Norman Woodridge conducted a Covid-19 Annual Inspection at the facility. Upon arrival, LPA informed Staff 1 (S1), of the purpose of the visit, completed temperature screening, and was granted entry into the building. LPA and S1 conducted a tour of the inside and outside of the facility, common areas, resident rooms, garage, and kitchen.

LPA discussed and observed the following:

There were 2 staff and 3 clients present at the facility. Client rooms were clean and organized. LPA observed a 2-day supply of perishables and a 7-day supply of nonperishables. LPA observed hallways and walkways that were free of obstruction. LPA observed PPE stockpile in the staff room. LPA reviewed Covid-19 policies, procedures, and sign in sheets. LPA and administrator, Dante Benedicto, discussed signage and Provider Information Notice 21-38-ASC: Update Guidance for the Use of Masks, Surgical Masks, Respirators Related to Coronavirus Disease 2019 (COVID-19). LPA discussed COVID-19 surveillance testing, COVID-19 clearance testing, quarantine, isolation, staffing, PPE, protocol for staffing shortages, and communication.

No deficiencies were noted during the inspection.

An exit interview was conducted with AD and a copy of this report was provided.