Facility Evaluation Report

On November 5, 2021, at 8:30am, Licensing Program Analyst, LPA DeAnna Williams-Lyons arrived unannounced to conduct a required annual inspection. LPA met with , Administrator Doina and informed her the reason for the visit. Prior to initiating the inspection LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; and completed a facility risk assessment. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: mask.

LPA completed the inspection tool questionnaire with Doina no issues or advisories to report.

This is a 6 bedroom 2 bathroom home. Administrator certificate is valid and expires 7/4/2022. First aid kit fully stocked and ready for emergency use. Fire extinguishers fully charged. Smoke alarms and Carbon Monoxide detector are working Hot water temperature measured 105 degrees F. The facility temperature is 71 degrees F.

Common areas were clean and in good repair. Bedrooms had required furniture and lighting. Facility has required (2) day perishable supply of food and (7) supply of non-perishable food. Medication was properly stored and locked away. There are no bodies of water on the premises.