Facility Evaluation Report

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 06/27/2022 at 03:03pm. LPA met with facility Administrator Arielle Teodoro (Admin).

LPA toured the facility, including living room, kitchen, dining room, laundry room, 3 resident bedrooms, 3 staff bedrooms, 3 bathrooms, and back yard. Admin confirmed that all staff and residents have been vaccinated.

Facility Mitigation plan has already been submitted. No prohibited items noted in resident rooms. All emergency exits noted to be clear of obstruction. All rooms in facility noted to be clean and well maintained. Hand sanitizers, soap, and paper supplies were observed to be available. At least 2 days' supply of perishable food and at least 1 week's supply of non-perishable food was observed on the premises. Fire extinguisher observed to be last inspected in July 2021. All cleaning supplies and chemicals noted to be in locked cabinets and closets. Smoke/carbon monoxide detectors tested and observed to be operational.

Facility observed to have designated entry point. Staff took LPAs' temperature and screened for symptoms. 30 days supply of PPE was observed. Hand washing signs were observed in facility bathrooms. Paper towels were observed in resident bathrooms. Water temperature observed to be 107.8 *F in facility bathroom. Social distancing signs observed to be posted in all public areas.

No deficiencies cited during today's visit. This report was reviewed with Administrator Arielle Teodoro and a copy of the signed report was provided.