Facility Evaluation Report

On 5/4/2022 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA observed COVID-19 signs posted by the entrance. LPA was greeted by administrator, Sister Faustine. LPA explained the purpose of the visit and LPA was screened at the front entrance where there was a hand washing station, hand sanitizer, COVID-19 signs, and screening log.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident and staff daily monitoring records, containment strategies. there are 4 residents at the facility and all of them are residing in private rooms. PPE supply and the environmental cleaning supply are adequate, bathrooms are equipped with liquid soap and paper towels, and hand washing instruction is posted by the hand washing stations. All trash cans are observed to have lids. There a COVID-19 signs throughout the facility and there are 2 isolation carts with PPE supplies set up by each hallway.

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

No deficiency cited today. This report is reviewed and discussed with the administrator.