Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon arrived at 12:00 pm to conducted a 1 year annual visit to the facility above. LPA met with Licensee/Administrator Joe Castillo 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 submitted a current Mitigation Plan, Infection Control Plan, Emergency Disaster Plan and provided plans to the department. The facility has a sign in and out binder for visitors at entry with hand sanitizer and symptom screening. 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. New residents are tested and negative results received before residing in the facility. 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). All trash cans and waste baskets have tight fitting covers.

Physical Plant & Environment Safety: The facility is a 5 bedroom and 2 bathroom currently occupying 5 residents and employs 5 staff with 2 live-in staff using 1 bedroom and 1 bathroom. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. The facility has a carbon monoxide detector and smoke alarms. The lighting and lamps are sufficient for the use of the facility and for residents comfort. The showers have non-skid textured floors. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions and well lit. Disinfectant, cleaning solutions and poisons are locked and inaccessible to residents in care. The facility has sufficient space inside and outside for activities and visiting. The facility has telephone and internet service for resident use.

Operational Requirements : The facility has a current plan of operation and infection control plan 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 06/15/2024. The facility is approved for a capacity of 6 Non-Ambulatory and has a current Hospice wavier granted for 1.