Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an annual inspection visit, and met with administrator (ADM) Marlene Elliott. Upon arrival, ADM took LPA body temperature, asked the questionnaires of infection control and checked LPA into the guest book. Screening station with thermometer, masks, hand sanitizer was observed at the main entrance. COVID posters were observed at the main entrance and in facility. 2 residents were observed in facility.

LPA toured the facility inside and out with ADM. LPA inspected living room, family room, kitchen, dinning area, and laundry room. Knives closet, and cleaning product closet were observed locked. There are 2 bedrooms for residents, and two restrooms for residents. There are 4 bedrooms and two restrooms for ADM family. Paper towels were observed with holders, Some trash cans in facility were observed without covers. ADM stated the facility will replace the trash cans with covers within 5 days. Cloth towels were observed in kitchen and restrooms. No posters of washing hands for 20 seconds by the sinks in kitchen and restrooms, even though there were posters of washing hands in kitchen and restrooms. ADM stated the facility will replace the posters with posters of washing hands for 20 seconds within 5 days. Room temperature was observed at 69 degree F, and hot water temperature was observed at 106 degree F. 2 days perishable food supplies and 7 days non perishable food supplies were observed sufficient. PPE supplies were observed sufficient.

The facility is equipped with smoke and carbon monoxide detectors. ADM tested the smoke and carbon monoxide detectors, and they were working fine. The fire extinguishers were observed on service on 03/13/2022. LPA inspected the backyard, there was no obstruction to block the walkway. There was a swimming pool at backyard. There are fences with gates locked around the swimming pool. ADM stated all staff and residents are fully vaccinated and done with booster. ADM already submitted the Infection Control. Plan to LPA. No citation noted during inspection. Exit interview was conducted with ADM. This report was provided to ADM for signature.