Facility Evaluation Report

On 9/23/22, Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct an Annual Required Inspection. LPA Medina observed all COVID-19 safety measures in place upon entry. Staff observed to be wearing masks, sign-in, temperature checks, masks and sanitizer available at entry.

Facility observed to be clean and odor free. No fire hazards observed. All common areas have adequate seating available for residents. Bathrooms observed to have trash cans with lids. All residents have private bedrooms, with all required furnishings. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable available for residents.

Water temperature measured at 112 degrees F. Fire extinguisher has a service date of 1/12/22. Carbon monoxide detectors and smoke detectors observed to be operational during inspection.

LPA received copies of Infection Control Plan for Monkey Pox, Administrator Certificate, CPR card, Fire Drill Record, LIC 9020, Staff Schedule and LIC 610.

No deficiencies were observed. Exit interview was conducted. Report signed during inspection and a copy left for facility file.