Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa conducted 1 year required inspection and met with Administrator/ Licensee Van Truong. The inspection is focused on the Infection Control procedures and practices of this facility.

All visitors, essential visitors, and staff are screened upon entry; temperatures are taken, and screening questions are answered before being allowed to enter the facility, all information is logged. Residents are screened and observed for any changes, all information is logged. Facility was found to be clean, orderly, and at a comfortable temperature with all exits free from obstruction. Water temperature was tested and within 105 -110 degrees F in 3 out of 3 faucets. Toxins are stored in locked cabinets. There was a sufficient supply of hygiene products, cleaners, and paper products for use as needed. Medications were stored locked making them inaccessible to residents. Exit alarms were on exit doors and working properly. All bathrooms had grab bars, and non-slip mat/flooring for bathing as needed. Facility has a sufficient supply of personal protective equipment (PPE). Administrator/Licensee and staff had a mask on during the LPA's inspection. Facility has 4 residents. Mitigation plan was approved by the Department on 03/05/21. Fire inspection was done on 12/02/21 with no violations.

No deficiencies during today's inspection.

Exit interview conducted with the Administrator.