Facility Evaluation Report

Licensing Program Analyst's (LPA's) De Leon and Rankin arrived at 09:30 am to conduct a 1 year annual visit to the facility above. LPA met with Valentina Roberts and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted with Administrator. The following was inspected and noted during the annual visit:

Infection Control: The facility Infection Control Plan on file. The facility has a sign in and out clipboard for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, hand soap, and hand washing signs. The facility has a 30 day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). Some trash cans and waste baskets have tight fitting covers, administrator agreed to replace those without lids.

Physical Plant & Environment Safety: The facility is a 4 bedroom and 2 bathroom, with one staff room in the garage. The facility is occupying 4 residents and employs 9 staff of which one is the Administrator and one is a live in staff. The facility is clean, safe and sanitary. LPA's were authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors. Carbon Monoxide was tested and working properly. The lighting and lamps are sufficient for the use of the facility and for resident comfort.