Facility Evaluation Report

L icensing Program Analyst (LPA) De Leon arrived at 3:00pm to conducted a 1 year annual visit to the facility above. LPA met with Administrator Joni Chapman 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 submitted a current Infection Control Plan to the department. The facility has a sign in and out binder for visitors at entry 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 will be trained on infection control and the use of Personal Protective Equipment (PPE) intially upon hire and annual thereafter. All trash cans and waste baskets have tight fitting covers.

Physical Plant & Environmental Safety: The facility is a 5 bedroom and 3 bathroom currently occupying 6 residents and employs 6 staff, 1 Administrator and 4 on call back up staff if needed. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. The facility has smoke alarms and a carbon monoxide detector. The lighting and lamps are sufficient for the use of the facility and for residents comfort. The showers have non-skid bottom floors. 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 inaccessible to residents in care locked in laundry room cupboards, and storage closet. 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. Water temperatures were checked at kitchen sink measured 116.8 and in one the resident bathroom 116.6 F both within regulation requirements. Continued 809-C