Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted a post licensing inspection visit, and met with licensee (LNS) Jenny Mcdonald. Upon arrival, staff Yanfang Manak (YM) took LPA body temperature, asked infection control questionnaires, and checked PA in the visitor log book.

LPA toured the facility inside out with LNS. There are 6 single bedrooms for residents, 1 staff live-in bedroom, and one and half bathrooms in facility. LPA toured the kitchen, dinning room, family room. Not all the trash cans with covers, not all the paper towels with holders, and no washing hands poster around the sinks. LNS stated the facility will fix these issues in 3 days. 2 days perishable food supplies and 7 days nonperishable food supplies were observed sufficient. Knives closet, medication closet, and cleaning product closet were observed locked. PPE supplies were observed sufficient. 5 residents and 4 staff were observed in facility. Laundry area and garage were inspected.

Room temperature was observed at 70 degree F, and hot water temperature degree was observed at 115 degree F. The facility equips with smoke/carbon monoxide detectors. LNS tested the smoke/carbon monoxide detectors, and they were working fine. The fire extinguisher was serviced on 11/22/2021. LPA toured the backyard with LNS. There was no obstruction to block the walkway.

LNS stated all the residents and staff are fully vaccinated, and done with booster shots.

No deficiency or citation was noted today. Exit interview was conducted with LNS. This report was provided to LNS for signature. A copy of this report was emailed to LNS.