Facility Evaluation Report

Licensing Program Analyst (LPA) Ashley Smith arrived unannounced to conduct a required annual visit at 1:55 p.m. The LPA met with Administrator Lorraine Medina and explained the reason for the visit.

The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: Knives and chemicals are kept inaccessible to clients. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Medications are locked and inaccessible in a cabinet in the kitchen. BEDROOMS: The LPA observed the three staff rooms and the four client bedrooms. Bedrooms were observed with appropriate furnishings, clean linens and sufficient lighting. RESTROOMS: Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. At 2:20 p.m. water temperature measured at 132.4 F. Water tank was adjusted. COMMON SPACES: Furniture was observed to be in good condition. Files are kept inaccessible. Smoke and common monoxide detectors were tested at 2:05 p.m. and were operational. The backyard has a covered outdoor area with furniture for resident use. No bodies of water were noted. Side gate is self-latching.

INFECTION CONTROL: There was a central entry point for screening and temperature checks. The LPA was appropriately screened upon entry. Infection Control signs were observed at the entrance and throughout the facility. The facility’s cleaning protocol was sufficient. There was record of staff and client vaccinations. The Administrator is up to date regarding testing, visitation and vaccine requirements. Facility had a sufficient supply of Personal Protection Equipment (PPE) at this time. The facility's procedures as it pertains to infection control are adequate.

Observed deficiencies noted on LIC 809D. Exit interview conducted, and a copy of this report issued. Appeal rights discussed.