Facility Evaluation Report

On 12/8/2022, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA observed COVID-19 signs posted by the entrance. LPA was greeted by staff-in- charge, Rosemarie Palaoag who called the administrator and left a message informing LPA's visit. LPA explained the purpose of the visit and LPA was screened at the front entrance.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed. Facility has 1 private room and 2 shared rooms upstairs for residents and 2 private rooms downstairs- 1 for resident and 1 for staff. LPA observed beds in shared rooms to be 6" apart. PPE supply and the environmental cleaning supply are adequate, bathrooms are equipped with liquid soap and paper towels, hand washing instruction is posted by the hand washing stations.

Medications, toxins and sharps are stored appropriately and inaccessible to resident, a comfortable temperature is maintained, lighting is sufficient for comfort and safety and food supply was checked and observed to be sufficient. First-aid kit is inspected and complete.

There are 3 residents present during the inspection and 2 are at the day program.

During the inspection, LPA also observed facility was not able to provide documentation of the daily COVID-19 temperature and symptom screening checks.. According to staff, this was stopped in 2021.