Facility Evaluation Report

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility announced (due to in person services are closed at this time)on 9/16/21 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with staff and explained the purpose of the visit. Prior to initiating the annual 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 contacted licensee and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA were screened by facility staff upon entering the facility. Administrator is present at the facility to conduct an annual inspection.

LPA toured the interior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, bathrooms and activity rooms. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time.

LPA received updated copies of: LIC 500 and LIC 610- Emergency plan.

LPA provided a version of donning/ doffing PPE poster copy. LPA advised Fit Testing of N-95s and placing touch free trash cans where PPE may be disposed.

No deficiencies are being cited as a result of todays inspection.

Exit interview conducted and copy of report left at the facility.