Facility Evaluation Report

At 10:40am on 07/26/2022, Licensing Program Analyst (LPA) Jeffries arrived at that

facility to conduct and unannounced annual infection control inspection. LPA was met at

the front door by staff and asked to screen for COVID-19 protocols. LPA met with

Administrator Clementina Garcia and announced the reason for the visit.

Administrator and LPA conducted a physical tour of the facility. The facility is a 4

bedroom, 2 bathroom, kitchen, living room and laundry room set up, medication cart is

locked in the laundry room. LPA observed working fire/carbon-monoxide detectors in each

room in working order. LPA observed at least two days of non perishable and seven days

of perishable foods at this facility. LPA noted that there are 4 additional sister facilities on

the same campus and all meals are prepared at facility 405802304 and brought to each of

the five facilities for each meal. All staff have a single entry point at facility 405802302 and

each facility has a single entry point of all residence and visitors at the front door. LPA

observed an ample supply of PPE located in the garage of the facility and additional PPE

is located on the campus in the other facilities.

Administrator and LPA conducted the infection control module of the annual inspection

tool. LPA did not find any violations or deficiencies during the infection control module. At

this time there are no violations or deficiencies cited.

Exit interview, report singed, and repot emailed.