Facility Evaluation Report

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

There is one entry point to facility. Upon entry; temperatures are taken, and screening questions are answered before visitors are allowed to enter the facility and all information is logged. Residents are screened and observed for any changes daily; all information is logged.

Facility was found to be clean, orderly, and at a comfortable temperature with all exits free from obstruction. Toxins and sharps are stored in locked cabinets in kitchen and garage. There was a sufficient supply of hygiene products, cleaners, and paper products for use as needed. Medications were stored and locked in kitchen cabinets 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. All sinks had soap and paper towels. Each client's room was clean, well-organized and decorated for their individual interests. Facility has a sufficient supply of personal protective equipment (PPE).

Facility has 4 residents. Mitigation plan was approved by the Department on 03/05/21. The Infection Control Plan was submitted 08/2022. Fire inspection was done on 03/11/2022 with no violations.

The back yard had a garden area for residents to enjoy and participate in gardening activities.

No deficiencies were found at the time of inspection. No citations were issued. Exit interview reviewed with Administrator.