Facility Evaluation Report

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct an annual Required-1 year inspection and met with Angela Lofton, Licensee/Administrator. The annual inspection is focused on the Infection Control procedures and practices of this Adult Residential Facility. There is currently 1 client in care.

LPA toured facility and grounds with administrator and observed COVID-19 precaution signs posted in common areas to promote hand washing, cough etiquette. Visitors are said to be screened for COVID-19 symptoms upon arrival to the facility. Infection control practices are present: entry procedures, face coverings, daily monitoring and temperatures checked for clients and staff, and 30-day PPE supply. Facility will follow indoor visitation requirement of verifying and tracking COVID-19 vaccination or verify non-essential visitors have proof of a negative COVID-19 test. Facility states staff clean and disinfect the facility daily. Facility understands hand sanitizer should not be placed in the rooms of residents who lack hazard awareness and impulse control. Bathrooms are equipped with liquid soap and paper towels. Covid-19 Mitigation plan was submitted to the department on 8/12/2021. Caregivers have completed PPE training but have not been N-95 Fit tested. In addition, facility was found to be clean, at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be last charged and serviced on July 22, 2021.

LPA requested the following updated records to be submitted to Community Care Licensing by 7/15/2022

· LIC 308 Designation of Facility Responsibility

· LIC 400 Affidavit Regarding Client/Resident Cash Resources

· LIC 9020 Register of Facility Residents

Exit interview conducted with Angela Lofton, No deficiencies cited during today's inspection