Facility Evaluation Report

Today, Licensing Program Analyst (LPA) M, Medina conducted an unannounced Infection Control Inspection. LPA allowed entrance by Licensee Sharon Rogers. LPA completed the contact questionnaire prior to entrance into the facility. LPA conducted inspection with both Licensee Keith and Sharon Rogers.

Infection control procedures described in written and observed by LPA include: Daily symptoms screenings (for staff, persons in care and visitors), visitation policy, and quarantine/isolation procedures, surveillance testing, infection control. Facility has adequate PPE available which includes, gowns, gloves, hand sanitizers, N-95 and face shields. Facility has a binder for COVID for procedures, documentation, postings and communication.

LPA observed carbon monoxide and smoke detectors present and observed operational during today's inspection. Fire extinguisher has a service date of 4/23/2021 . Facility has a 7-day supply of non-perishable and 2-day supply of perishable foods on site. Facility has 2 shared rooms and 1 private room, shared rooms have beds that are 6 feet apart. Bathrooms are fully stocked with soap, and paper towels. LPA observed a 30 day supply of resident medications.

LPA observed the required infection control practices to be in compliance.

No deficiencies were observed. Exit interview was conducted. Administrator was informed that as a COVID-19 precautionary measure, this report will be emailed