Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa (JN) conducted a 1-year required unannounced inspection and met with Administrator Timothy Fickess. The inspection is focused on the Infection Control procedures and practices of this facility.

All visitors, essential visitors, and staff are screened upon entry. Temperatures are taken, and screening questions are to be answered before being allowed to remain in the facility, all information is logged. Residents are screened and observed for any changes, all information is logged. Facility was found to be clean, orderly, and at a comfortable temperature with all exits free from obstruction. Toxins are stored in locked cabinets. There was a sufficient supply of hygiene products, cleaners, and paper products for use as needed. Medications were stored locked making them inaccessible to residents and staff that do not handle medications. All bathrooms had non-slip mat/flooring for bathing as needed. All postings were up and visible to all as required. Facility has a sufficient supply of personal protective equipment (PPE). LPA left additional N-95 and surgical masks. Administrator, staff, and 1 of the four residents were wearing masks during the LPA's inspection. Mitigation plan was approved by the Department on 07/29/2021. Fire clearance is approved for 4 residents. The fire extinguisher was serviced on July 16, 2021. There was one carbon monoxide detector and a hard-wired central fire detection/sprinkler system. All staff are current on CPR/First Aid Training.

There were 4 residents in care at the facility during this inspection.

No deficiencies during today's inspection.

Exit interview conducted with the Administrator.