Facility Evaluation Report

Licensing Program Analyst (LPA) Tammer de los Santos and Licensing Program Manager (LPM) Denise Powell, visited the facility to conduct an annual required licensing inspection. LPA and LPM were granted entry into the facility by Arturo Camacho, Director and Denise Quijas, SIte Coordinator to whom he disclosed the purpose of the visit.

During today's visit, LPA and LPM toured the facility and verified compliance with infection control practices. LPA and LPM observed one central entry point for universal entry screening; temperature check initiated at entry for staff, residents, and visitors; a sign-in policy enacted for visitors; signs in the facility to promote hand hygiene, cough/sneeze etiquette, symptom and transmission awareness; face coverings worn by staff; hand sanitizer readily available; available visitation area; emergency agencies’ contact information visible to staff; and an ample supply of cleaning products and Personal Protective Equipment. LPA & LPM provided additional guidance on exceptions and waivers and gave copies of Provider Information Notice PIN 22-13-ASC

Director provided a copy of the completed Infection Control Plan which was reviewed and in compliance.

No deficiencies were cited during today’s visit. An exit interview was conducted with Arturo Camacho, Director, and copies of this report and Licensee Rights (LIC 9058) were provided to the Director at the conclusion of the visit. Arturo Camacho's signature on this form acknowledges receipt of the rights and a copy of the report.