Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon arrived at 10:20am to conducted a 1 year annual visit to the facility above. LPA met Administrator Jennifer Lawrence 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 a current Infection Control Plan on file with the department. The facility has a sign in and out clipboard for visitors at entry in the garage area with hand sanitizer. The bathrooms have toilet paper, paper towels, hand soap, and hand washing signs. 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 and the use of Personal Protective Equipment (PPE).

Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 06/01/2027. The facility is approved for a capacity of 6 Non- Ambulatory of which 2 may be bedridden in bedroom 1.

Physical Plant & Environmental Safety: The facility is a 3 bedroom and 2 bathroom currently occupying 6 residents and employs 7 staff and 1 Administrator. The facility is clean, safe and sanitary. 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 facility kitchen is clean, safe and sanitary. The showers have non-skid mats. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. 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. The facility has a backyard and front yard for client use with plenty of shade. The facility has telephone and internet service for resident use. Continued 809-C