Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin arrived at 9:06 am to conducted a 1 year annual visit to the facility above. LPA met Administrator Rebecca Michel 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, and Emergency Disaster Plan. The facility has a sign in and out clipboard 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 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 has 14 bedroom and 4 bathrooms for resident use currently occupying 15 residents. 1 restroom is designated for staff and visitors. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors, fire system is checked annually by an alarm agency, carbon monoxide tester was tested and working during the visit. 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 showers have non-skid mats.