Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual visit. This annual visit had a specific emphasis on infection control practices and procedures. The LPA met with staff and reason for visit was explained. Staff contacted Administrator. LPA was informed that staff may assist with todays inspection.

At approximately 2:45pm today, LPA and staff toured the physical plant areas inside and outside to ensure the facility is in compliance with Title 22 Regulations: KITCHEN: Knives are stored inaccessible to the clients. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. BEDROOMS: The LPA observed the bedrooms (3 resident rooms and 1 staff), which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. RESTROOMS (2): resident restrooms observed clean/sanitary and in operating condition. Restroom observed stocked with liquid soap and paper towels; appropriate hand-washing signs observed posted. COMMON SPACES: common areas adequate furnitioned. The appropriate licensing documents and infection control postings observed posted throughout the facility. The backyard observed hazardous free; with patio furniture for residents use. INFECTION CONTROL: During today’s visit, the LPA spoke with the staff and Administrator regarding the facility’s infection control practices. Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. The LPA observed an adequate supply of Personal Protection Equipment (PPE) observed; additional surgical mask shall be maintained at facility for staff use. LPA observed 1 box during todays visit. Staff reported that they will inform Administrator when supply is low. The administrator's cleaning protocol is in place. Facility observed clean during todays visit.

If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility does not have a confirmed case of COVID-19 at this time; however, the facility’s policies and procedures as it pertains to infection control appeared to be in compliance during todays visit. .

No deficiencies observed during todays visit. Exit interview conducted. Copy of report provide.