Facility Evaluation Report

On 8/27/22 at 1:47 pm, Licensing Program Analyst (LPA) Chavez conducted an unannounced on-site annual infection control visit to the facility listed above. LPA explained the purpose of the visit to staff who then contacted administrator. At 2:10 pm, Victoria Thorne, Administrator, arrived and LPA explained the purpose of the visit.

LPA toured the facility with the administrator and observed the following: The facility has infection control signage at the front door and signage throughout the facility on handwashing, cough etiquette and use of masks. Upon entry to the facility, LPA was not screened, however, when the administrator arrived at 2:10 pm, LPA was screened. Staff are wearing masks. The facility has soap and paper towels in resident bathrooms and in the kitchen. The fire extinguisher is located in the dining room. The extinguisher is fully charged and inspected on 5/12/22. At 2:50 pm, administrator states that Resident #1 (R1) has dementia. LPA confirmed on R1’s physician report. R1’s last annual medical assessment was 8/24/21. R1 is overdue for an assessment. Deficiency cited.

At 4:42 pm LPA conducted the Infection Control mitigation module with the administrator. No deficiencies cited from the module.

Exit interview conducted, deficiencies cited, and the report and appeal rights emailed to the administrator.