Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin arrived at 9:10 am to conducted a 1 year annual visit to the facility above. LPA met Licensee/Administrator Gabriella Soo and explained the purpose of the visit.

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

Infection Control: The facility has submitted a current Infection Control Plan. The facility has EPA approved disinfectants spray and cleaners. The facility has a 30 day supply of PPE. The facility is provided annual training for infection control with all staff.

Physical Plant & Environment Safety: The facility is a 5 bedroom and 3 bathroom home currently occupying 6 residents and 3 staff and 2 administrators. The facility is clean, safe and sanitary. The pathways are clear of any obstructions. The facility has sufficient space inside and outside for activities and visiting. The gates are self-latching and self-closing. The facility has table and chairs available outside with shaded area for resident use. Laundry room has working washer and dryer.

Operational Requirements: The Facility is operating in compliance with fire clearance. The facility provided current up to date liability insurance. The facility is granted for 6 non-ambulatory with 1 can be bedridden and Hospice wavier granted for 4.