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25 | Licensing Program Analyst (LPA) Gary Tan conducted an unannounced visit at this facility for a One (1) year Required visit. LPA met with administrator Amy Simityan and explained the purpose of the visit.
A tour of the physical plant was conducted at 9:30 AM. The facility has four (4) bedrooms and two (2) bathrooms currently occupying six (6) residents on two (2) private rooms and two (2) shared room. One (1) bathroom is designated for the staff. The facility fire cleared for six (6) non-ambulatory residents, one of which may be bedridden. The garage is converted into an staff rest area and storage room.
There is only one entrance being utilized at the facility, there are required poster posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation plan and Infection plan.
Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked, the following was noted:
Living and dining room furniture were also checked. The living room is neat and clean along with the family room. The facility maintains a comfortable temperature at 75°F. The carbon monoxide and smoke detector are tested and observed to be operational. Smoke detectors are hardwired and interconnected. Fire extinguisher was observed to be full and last inspected on 07/03/23.
The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water at the facility.
(continued on LIC 809-C) |