Facility Evaluation Report

At 8:25am, on 02/04/2023, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to

conduct the annual, infection control inspection. LPA was properly screened upon entrance in accordance with

current infection control best practices. LPA met with licensee, Amaylyn Deliema, and announced who he was

Licensee and LPA conducted a cursory tour of the entire facility. This facility is a five bedroom, three

bathroom, living room kitchen and dining room layout with laundry room and garage, there is an backyard patio

with umbrella for shade. Medications are locked in a cabinet in the dinning room area and staff and client files

are locked in a enclave of the dining room. The facility has battery operated fire alarms in each room that are

all working and in the green, the carbon monoxide detector is in the hallway and functioning normally. All the

door ways and exits are free and clear of debris and hazards. LPA observed a working fire extinguisher near

the kitchen dining room area. LPA tested facility water and was within regulation temperatures 105*-120* (f).

LPA observed at least 2 days of perishable and at least 7 days of non perishable foods. LPA observed a 30

day supply of PPE and incontinence supplies on hand at the facility. LPA observed liquid soap and paper towel

dispensers in all bathroom of the facility. LPA noted that the facility was clean and in good repair. LPA noted

that the cursory tour did not indicate any violations, technical or citations during the cursory tour walk through.

Licensee and LPA conducted the infection control module of the annual inspection. LPA noted that there

were no citation, technical or citations issued during the infection control module of the annual inspection. LPA

noted that there were no violations, technical or citations issued during this annual inspection.

Exit interview, report signed, and report given.