Facility Evaluation Report

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct an annual inspection. LPA met with Caregiver Jean Gonzales during today's inspection, and informed Administrator Ida Redhair that LPA was completing an 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. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Masks. Additionally, LPA was screened by staff upon entering the facility.

Currently there are 3 clients living at the facility. 1 of 3 clients were at program during today's inspection. LPA toured the facility and inspected the interior and the exterior of the facility including the common living spaces, 4 client bedrooms and 2 bathrooms, kitchen and garage. Bathrooms and bedrooms were clean and in good repair. LPA toured the backyard and all exits are accessible and unlocked. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguishers were found to be up to date and charged. LPA observed an adequate amount of linens and PPE supplies.

LPA reviewed 2 of 3 resident records and 2 staff records. LPA reviewed medications of two resident comparing with Centrally Stored Medication Record and physician orders and reviewed 2 of 3 client P&I records. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility.

During today's inspection, no deficiencies have been cited. LPA printed PIN 22-01 and 610D for facility to update their emergency disaster plan.

Exit Interview conducted and appeal rights given.