Facility Evaluation Report

Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Lead Staff Nita Astorga and discussed the purpose of the visit. LPA and Lead Staff Nita Astorga began the tour at the front entrance/office of the facility. LPA contacted Administrator Sharon Butler who gave permission for Lead Staff Nita Astorga to conduct the visit and sign for this report.

Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed under sink in kitchen. LPA observed the following personal protective equipment in a storage cabinet/closet; gowns, face shield, gloves, and masks. Staff records were reviewed for infection control training. LPA observed all facility staff wearing masks.

Resident’s files have updated emergency contact information.

Exit interview was conducted and a copy of this report was provided