Facility Evaluation Report

At 9:45 AM on 8/26/2021 Licensing Program Analyst Hansen arrived unannounced to conduct a required Annual 1 yr. Infection Control inspection and was met by Administrator Helen Rabago who took LPAs temperature and logged results in visitor’s binder. Facility has 3 residents at this time that has a capacity of 6.

The facility was a comfortable temperature, free from obstructions and was well lit. There was a sufficient amount of perishable and non-perishable foods in the kitchen and garage. Extra hygiene products and linens were available and required bathmats and grab bars were observed. Water temperature in resident's bathroom measured 119.8 degrees F which is within acceptable range of 105 to 120 degrees F. Cleaning products and other toxins are located in locked cabinet in the garage. Knives/sharps are kept in a locked cabinet in the kitchen. Medications were centrally stored and locked in a kitchen cabinet as well. Staff & Residents with facility files are kept in living room cabinet (office). Fire extinguisher located in the living room was last inspected 7/12/2021. Smoke detectors located throughout the facility and carbon monoxide detector were tested and functional. Annual Fire Inspection was held on 7/12/2021. Exit doors have auditory alert system.

Administrator told LPA last disaster/fire drill was in 2020 and are usually practiced quarterly but due to COVID they have been concerned about safety issues. Administrator informed LPA they would complete a drill soon and submit time to LPA Tobola along with copies of current 1 st Aid and CPR certificates as she is unable to find but is certain they are current.

Facility has submitted a mitigation program plan that has been approved. Posters have been placed at facility and entrance has small table with hand sanitizer and other items designated for visitors and staff before coming into work. Facility has PPE supply stored in hallway closet & garage. Facility has a 30-day supply of medication for residents. Residents aren’t wearing masks inside the facility. All staff had masks on during this visit.