Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon arrived at 11:00 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 with Administrator. The following was inspected and noted during the annual visit:

Infection Control: The facility has submitted an 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, 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) initially upon hire and annually thereafter.

Physical Plant & Environment Safety: The facility has 14 bedrooms (1 shared room), 4 bathrooms, and 1 shower room for resident use currently occupying 15 residents. 1 common area restroom designated for staff and visitors. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. The facility has smoke detectors which are hard wired. The facility has a sprinkler system. The facility has 3 carbon monoxide detectors. The facility has the fire system inspected annually and administrator provided the current report. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. Non-slip mats and textured bottoms on the shower floors are present. All 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. The laundry room has a working washer and dryer. The facility has sufficient space inside and outside for activities and visiting. The facility has a courtyard for resident use with an umbrella for shade and self-closing, self-latching coded delayed egress gate to exit. The facility has 5 doors with delayed egress. The facility has telephone and internet service for resident use. The facility has three sitting areas throughout the facility for resident use. Continued 809-C