Facility Evaluation Report

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 02/22/2022. LPA met with Administrator Eleanor Basa (Admin).

LPA toured the facility, including living room, kitchen, dining room, 4 bedrooms, 1 visitor room, 2 bathrooms, garage, laundry room 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 extinguisher observed to be inspected in January 2021. Admin stated that she is currently in the process of arranging the necessary inspections for all of her emergency fire supplies.

Facility observed to have designated entry point. Staff took LPA's temperature and screened for symptoms. Facility did not have a 30 day supply of PPE, as they had no gowns on the premises. Restrooms were not stocked with paper towels and did not have lidded trash cans. Admin confirmed that the would replace the trash cans and supply paper towels in the bathrooms. Water temperature observed to be 114.8 *F. Hand washing signs observed in all bathrooms. Social distancing signs observed to be posted in all public areas.

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