Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon arrived at 10:00am to conducted a 1 year annual visit to the facility above. LPA met with Licensee Gabriela Soo and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit:

Infection Control: The facility has a current Infection Control Plan. The facility has a sign in and out binders for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, and hand soap. The facility has EPA approved disinfectants spray and cleaners. The facility has a 30 day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control, the use of Personal Protective Equipment (PPE) and universal precautions.

Physical Plant & Environment Safety: The facility is a 4 bedroom and 4 bathrooms currently occupying 6 resident and employs 2 full time staff, 1 back up staff and 2 Administrators. LPA was authorized to enter and inspect facility. The facility has dual smoke and carbon monoxide detectors. The lighting and lamps are sufficient for the use of the facility and for resident comfort. The kitchen is clean, safe and sanitary. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have non-skid mats. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents in care locked in garage or storage closet. The facility has sufficient space inside and outside for activities and visiting. The facility has an a backyard for resident use with plenty of shade. The facility has telephone and internet service for resident use. Laundry room and garage are kept locked. Facility has a working washer and dryer present. The facility has 3 ponds 2 ponds have river rock in them so the water is not deep in either, 1 pond currently has not water present. The facility has two fountains a small one on the side of the house and it is filled with rocks, one fountain in by the front entry door, it is large and currently not in use, if the facility starts to use it again LPA recommended river rock in the bottom tier so it would not be deep if not going to use put plants in it so it does not feel with water if it rains. Continued 809-C