Facility Evaluation Report

At 9:00am on 09/17/2021, Licensing Program Analyst (LPA) Jeffries conducted a screening call with Staff Emanuel Luis-Roman to get facility COVID-19 status. No residents or staff with any symptoms or positive status, additionally, the facility had conducted third round mass of testing the day prior (09/17/2021) due to current positive status.

At 9:15am, due to the facilities current COVID-19 positive status, LPA dawned full Personal Protective Equipment (PPE) and then entered the facility. LPA conducted a cursory tour of the facility with staff Emanuel Luis-Roman. The facility is a 4 bed room 2.5 bath with office laundry room, dining room and two common room living areas. LPA observed COVID-19 precautions and reporting instructions on the wall of the facility as well as all required posted information per regulations on facility wall in common area of the dining room and the staff office. LPA observed each room was properly equipped and outfitted per regulations. LPA observed all three bathrooms to be stocked and functioning per regulations. LPA observed a medication cart in the second living room that was secured by lock and key. LPA observed more than two days of perishable and 7 days of non-perishable foods. LPA observed working smoke detectors/carbon monoxide detectors in all rooms and the hallway of the facility. LPA observed all hazardous material were locked in by lock and key in the laundry cabinet and all sharps were secured in the staff office. LPA observed the facility single entry point log-in book and all staff currently at the facility had been screened for COVID-19 and logged in prior to their shift. The facility was clean and appeared to be free of any hazards on the cursory Infection Mitigation Control Inspection. At 10:21am LPA conducted the Infection Mitigation Control Module of the Inspection with Administrator Jeannett Mack . LPA reminded Administrator that all persons who enter the facility need to be screened for COVID-19 prior to entry to the facility. LPA also reminded Administrator that all staff must have a mask on at all times while in the facility. LPA and Administrator completed the Infection Mitigation Control Module of the inspection.

Exit Interview, no citations issued, report emailed