Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Administrator Roslyn Gray and explained the reason for the visit. Administrator Roslyn Gray has an administrator certificate expiring on 04/02/2023.

At 9:01 AM , LPA toured the facility. Facility has 1 client in care. Client is at work during the visit. Facility appears clean and sanitary. All client rooms had the required elements as well as restrooms stocked with soap/ sanitizer. Rooms are single occupancy. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the entrance of the facility. Facility does not utilizes a visitor sign in sheet. Facility has covid precaution postings as well as all required department postings. LPA observed the first aid kit has all required items. Facility mitigation plan has been approved. LPA observed an ample supply of emergency food and water. LPA toured the outside grounds and observed the shaded outside visitation area. Exit gates are unlocked. LPA observed the locked medication storage area. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. All clients and staff are vaccinated for Covid-19.

LPA consulted with Administrator regarding the importance of documenting visitor/ client temperatures and status of symptoms upon entry into the facility as well as the importance of a sign in sheet for visitors..

Based on the observations made during today's visit, No deficiencies are being cited. Exit interview conducted and a copy of this report was left at the facility.