Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon arrived at facility for an unannounced annual inspection visit. LPA met with Administrator Brenda Victoria and explained the purpose of the visit.

LPA toured the inside and outside of the facility with Administrator the following was noted:

Infection Control: The facility has an infection control plan on file. The facility is clean, safe and sanitary. The facility trains staff initially upon hiring and annually thereafter on infection control and PPE. The facility has about a 30-day supply of PPE on hand. The facility has a book to sign in an out for visitors at the facility and hand sanitizer is present.

Operational Requirements: The facility is in compliance with the granted fire clearance. The facility is licensed for a capacity of 6, 5 of which can be non-ambulatory residents. The facility has an approved hospice waiver for 5.

Physical Plant & Environmental Safety: The facility is a 5 bedroom and 2 bathroom home currently occupying 6 residents. The facility has smoke detectors and 1 carbon monoxide monitor. The lighting and lamps in resident rooms are sufficient for the use of the facility and for resident’s comfort. The facility kitchen is clean, safe, and sanitary. The showers have non-skid mats. Toilet, hand washing and bathing facilities are operational. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are locked in laundry room and under the kitchen sink. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard for client use with plenty of shade. The facility has telephone and internet service for resident use. The facility has fencing around the back yard with a self closing and self latching gate.