Facility Evaluation Report

Licensing Program Analyst (LPA) Marybeth Donovan conducted a Technical Assist (TA) Visit via FaceTime with Virgilio Caruz Administrator, Sarah Yip Licensing Program Manager and Toni Rivera Program Clinical Consultant Nurse, to provide technical assistance to prevent and mitigate the spread of COVID 19 in the facility. LPA conducted a virtual tour of the facility.

During today's TA-Visit, recommendations were discussed as follows:

1. Notify Local Public Health of Positive case within 24 hours.

2. Post Sign to Wear Mask Before Entering the facility.

3. Complete Training on Donning and Doffing of PPEs.

4. Review OSHA Guidelines on N95 Fit Testing for staff.

5. Maintain COVID 19 Symptom Screening Log Sheet

6. Do not hang cloth towels in the bathrooms and maintain supply of paper towels available for use

LPA to forward CDC Posters for Donning and Doffing of PPE, Social Distancing, and informational Links on PPE usage and Provider information Notification (PIN) 22-04-ASC. Supply of PPEs to be provided to facility.

Report reviewed with Virgilio Caruz and copy emailed for signature.