Facility Evaluation Report

On today’s date, Licensing Program Analyst (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA Quiroz was greeted and granted entry into the facility by caregiver Patrick Guillemer. During today's visit, LPA Quiroz called Licensee/Administrator (L/AD) Cynthia Barton introduced self and discussed purpose of the call. Caregiver Rose Breton arrived to facility on or about 11:08am. L/AD Cynthia Barton arrived to facility on or about 12:00pm.

This facility is licensed to provide services to 4 Non-Ambulatory residents. (L/AD) Cynthia Barton has an Administrator Certificate with expiration date of 1/14/2022. L/AD Cynthia Barton indicated "Hoping to complete by April 15, 2022 due to COVID-19."

On or about 11:12am, LPA Quiroz reviewed 1 of 1 resident records.

On or about 11:25am, LPA Quiroz along with Caregiver Rose Breton toured the inside and outside of the facility. There is one (1)resident in care and there are no active COVID-19 cases. During today's inspection visit, LPA Quiroz observed one (1) resident in living room resting interacting with staff. One of One resident present in the facility appeared to be clean and well taken care of. LPA Quiroz did not observe required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed to have ample soap/sanitizer and appeared clean. LPA Quiroz inspected residents’ bedrooms and appeared clean and sanitary. All bedrooms observed to have all required components. LPA Quiroz did not observe a COVID-19 check in station in the main entry of the facility. LPA Quiroz inquired about visitor sign in sheet/Log and COVID-19 screening check in station, Caregiver Rose Breton indicated "We don't have a thermometer and we don't have a visitor sign in sheet/ log either."