Facility Evaluation Report

Licensing Program Analyst (LPA) Melody Brown arrived at the facility 02/17/2022 at 10:00 AM unannounced in order to complete the facility's Annual Inspection. LPA Brown met with House Manager Patricia Roggenbuck and advised of the purpose of the visit, and that the Annual Inspection will be limited to Infection Control only. Administrator Christopher Tanabe was contacted and later arrived during the visit. Below is a summary of what was observed:

Infection Control: LPA Brown went over COVID-19 best practices for infection control and prevention with House Manager Roggenbuck and Adinistrator Tanabe and they reported that Mitigation Plan was submitted January 2021. LPA Brown requested Administrator Tanabe to send a copy of Mitigation Plan via email.

LPA Brown observed the facility having Covid-19 signages throughout the facility for proper hand washing procedure, social distancing. LPA Brown toured the facility's resident bedrooms and bathrooms and observed that both resident bathrooms have paper towels and hand soap. LPA Brown requested to inspect the facility's Personal Protective Equipment (PPE) supply. LPA Brown observed the facility to have a sufficient supply of sanitizer, gloves, masks, and face shields/goggles or isolation gowns. LPA Brown went over the various recommended training for facility staff with Administrator Tanabe in relation to COVID-19 and informed Administrator Tanabe staff needs to be trained on various aspects of infection control, recognition of symptoms of COVID-19, and donning/doffing of PPE.

LPA Brown inquired as to if staff have been fit tested for N95 masks, and Administrator Tanabe informed LPA Brown that at this time staff have not been fit tested. LPA Brown will be issuing a deficiency during today's inspection for staff not being fit tested for N95 masks. LPA Brown will be issuing a deficiency for this item due to the facility just had COVID-19 positive resident last month, and N95 masks needs to be *** Continuation in LIC809C ***