Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon arrived at 1:50pm to conducted a 1 year annual visit to the facility above. LPA met with Back up Administrator Leticia Ruiz 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. The facility has a sign in and out clipboard 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 and the use of Personal Protective Equipment (PPE).

Physical Plant & Environmental Safety: The facility is a 4 bedroom with 3 bathrooms, kitchen, dining room, locked laundry room, locked storage room off the master bathroom, locked medication closet currently occupying 5 residents and employs 8 staff. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. The facility has 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 knobs are taken off stove to make it inaccessible to dementia residents in care, the hall has a sliding gate that closes off to the kitchen at night and it does not lock. 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 the laundry room. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard with in enclosed patio and an open patio for resident use with plenty of shade. The facility has telephone and internet service for resident use. The facility has video surveillance in the common areas without voice or sound capability for privacy purposes. Cont. 809-C