Facility Evaluation Report

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required 1 - Year Visit. LPA was greeted by Staff Juan Francisco Valles, identified himself, and discussed the purpose of the visit. Licensee Leena Dost arrived during the visit.

LPA conducted a tour with Licensee Leena Dost. In accordance with the Department’s Infection Control program, LPA provided technical assistance and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan (LIC 808).

LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy, and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE (Personal Protective Equipment). Based on observations, the facility is in compliance with and has implemented infection control practices as outlined in its LIC 808.

No deficiencies were observed during today's visit. An exit interview was conducted with Licensee Leena Dost, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail. Licensee Leena Dost will confirmed receipt of this report.