Facility Evaluation Report

01/03/2021 1:00 PM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year Inspection. The Infection Control domain was not available to this facility on the day of the visit. As a result, LPA Knight selected Annual Continuation for the visit. LPA asked all pertinent infection control questions during the visit. LPA met with administrator Jeremy Potter and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask, gloves. Additionally, LPA Knight was screened by Jeremy Potter.

LPA Knight and Mr. Potter toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, storage areas, and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA Knight and the administrator completed the infection control inspection and facility was found to be in substantial compliance at this time.

No deficiencies are being cited as a result of todays inspection. Technical assistance was provided. Administrator will purchase and stock an isolation cart to store at the facility.

Exit interview conducted and copy of report was emailed to administrator Jeremy Potter.