Facility Evaluation Report

On 12/21/22 at 10:53 am, Licensing Program Analyst (LPA) Chavez conducted an unannounced on-site annual infection control visit to the facility above. LPA met with Staff #1 (S1) and explained the purpose of the visit. At 11:40 am, Donna Pieprzycki, RN Consultant, arrived at the facility, and LPA explained the purpose of the visit.

LPA toured the facility with S1 and observed the following: The facility has infection control signage at the front entrance and throughout the facility on handwashing, cough etiquette and use of masks. Staff are wearing masks. The facility has soap and paper towels in resident bathrooms (2). Fire extinguishers (2) are located near the nurses’ station and in the hall leading to the garage. The extinguishers are fully charged and were inspected on 12/7/22 and 12/8/22 respectively. The door leading from the hall to the garage is unlocked and can only be locked from inside the facility. The garage has ten gallon size bottles of cleaning supplies and a storage unit of cleaning supplies that was unlocked. Staff immediately secured these items in the locked shed in the backyard. Licensee will secure the internal garage door so that residents cannot access these items, take a video, and send to LPA by end of day 12/22/22. The facility has a minimum seven-day supply of non-perishables and two-day supply of perishables. The entrance to the facility has a “No Visitor” sign. LPA educated staff on the fact that visitors must be allowed, and the entrance has other applicable signage regarding visitor guidance, and requested staff to remove the No Visitor sign which staff did so immediately.

At 12:07 pm, LPA conducted the Infection Control mitigation module with the nurse consultant. No deficiencies cited.

Exit interview conducted and the report emailed to the administrator and nurse consultant.