Facility Evaluation Report

Licensing Program Analyst (LPA) Marybeth Donovan conducted a Technical Assist (TA) Visit via Zoom platform with Obed Apostol Administrator, Lori Kopplinger RN,Program Clinical Consultant, and Jackie Jin Licensing Program Manager to provide technical assistance to prevent and mitigate the spread of COVID 19 in the facility. LPA conducted a virtual tour of the facility.

During today's TA-Visit, recommendations were discussed as follows:

1. Review PIN 22-07-ASC Dated 2/8/2022 to include Visitation Guidelines

2. Post Hand Washing signs in bathrooms and use paper towels instead of cloth towels

4. Place PPE supply cart next to Isolation Room

5. Review OSHA N95 Fit Test Requirements for staff working with COVID 19 Positive residents

6. Conduct additional training on Donning and Doffing of PPEs

7. Use disinfectants with 2 minutes or less wet time

8. Set up Screening station outside or inside next to the entry door to include updated visitor log with COVID . screaming symptoms, hand sanitizer and thermometer.

9. Update resident log and staff log to include the update COVID 19 Screening Symptoms as well.

10. Review COVID 19 Mitigation Plan and update as warranted

Report reviewed with Obed Apostol Administrator and a copy emailed for signature.