Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's annual inspection focusing on infection control. LPA met with Licensee, Olga Atienza-Bilan.

During visit, LPA toured the facility to include the resident bedrooms, staff bedroom, bathrooms, office, living room, kitchen, garage, and backyard.Facility has a central entry point for temperature check and visitor sign-in. LPA advised to create a symptom screening questionnaire to initiate at entry for all visitors, staff, and residents. Visitor guidelines posted at entry. Hand sanitizer made available at entry. Bathroom #1 supplied with hygiene products. LPA advised to place a hand washing sign and paper towels. LPA asked Licensee to remove all shared cloth towels in the bathrooms. Bathroom #2 supplied with hygiene products and paper towels. LPA advised to place a hand washing sign next to the bathroom sink. LPA did not observe a complete supply of Personal Protective Equipment (PPE). LPA reviewed facility's infection control plan. Staff are not N95 fit tested. Documents obtained during visit to include facility's LIC-500.

LPA observed an individual residing at the facility without association.

A deficiency was cited during today’s visit, see LIC 809-D. A civil penalty is being assessed for the amount of $100, for staff S1 residing at the facility without association. Please see LIC 421BG. Advisory notes provided.

This report was reviewed with Licensee, Olga Atienza-Bilan and a copy of the report will be emailed to the Licensee due to technical difficulties with the LPA's printer.