Facility Evaluation Report

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 04/06/2022. LPA met with facility staff member Cecilia Caday (S1). Administrator Roger Caday (Admin) was at the doctor's office with a facility resident, and was unable to attend the inspection. Admin gave S1 permission to lead the inspection in his stead.

LPA toured the facility, including living room, kitchen, dining room, 5 bedrooms, 2 bathrooms, garage, and back yard. All staff members observed to be wearing masks. 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 extinguishers observed to be inspected in February 2022. Smoke detectors tested and observed to be fully operational.

Facility observed to have designated entry point. Staff took LPA's temperature and screened for symptoms. Facility observed to have a thirty day supply of PPE on the premises. Hand washing signs observed in all bathrooms. Social distancing signs observed to be posted in all public areas. Both bathrooms observed to have had lidded trash cans.

Water temperature observed to be 136.5 *F, which is 16.5 degrees over the maximum.

Deficiency cited during today's visit. See 809-D. This report was reviewed with facility staff member Cecelia Caday and a copy of the signed report was provided.