1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual visit using the Infection Control Practices Domain. LPA met with Administrator Evangelina Reyes and explained the reason for the visit. The facility is licensed for a capacity of 14 residents, of which 11 may be non-ambulatory and 3 bedridden. There is an approved hospice waiver for a maximum of 5 residents.
LPA toured the facility and observed/inspected the following:
* There are 9 bedrooms, 7 bathrooms (2 for common use and 5 in the residents' room), living room with dining area, kitchen, and a detached garage.
* The garage has 2 individual rooms used as storage and a bathroom. There are 2 refrigerators stocked with extra perishables. The laundry area is also set up in the garage.
* COVID-19 signage are posted throughout the home. LPA recommended to post the signage at the main entrance and coughing/sneezing etiquette signs around the house.
* The facility has at least 30 days of PPE supplies in storage.
* Cleaning solutions and knives are locked and inaccessible to residents.
* There are adequate food supplies of 2 day perishable and a week of non-perishable.
* Staff were wearing face coverings.
* The fire alarm system which is connected to the fire department was last inspected on 1/28/22.
* The 3 carbon monoxide detectors were tested and operable.
* The hot water temperature was measured between 105-120 degrees Fahrenheit.
* LPA randomly selected 5 residents medication log for review. The medications were all listed on the MAR log and are being dispensed according to the physician's order.
LPA provided technical assistance on the following item: N95 respirator fit testing
No deficiencies were observed during the visit today. An exit interview was held and a copy of this report was provided. |