We at Garden House, Morro Bay are doing everything in our power to protect the physical and mental health of our residents. We have been updating our response according to updates from the CDC, Federal, State and County guidelines as well as Community Care Licensing Division (CCLD – our licensing). Our Admin team checks the County Numbers and the County Press Releases, updating the staff on pertinent information. The staff has received an additional training on infectious disease transmission, control, and care, COVID-19 specific symptoms and care, stress and coping, PPE, and cloth mask care and creation. 

You may print and fill out the Visitor Screening Form before you come in as long as the information is true and correct. Please fill it out on the day of your visit to make sure the information is accurate.  

We have made some changes to the visitation guidelines. based on direction from Dr. Rick Rosen MD, San Luis Obispo Public Health Deputy.

• Call ahead to make appointments for visitation or outings/walks
• Visitors must fill out screening form and record temperature checks during every visit. I have attached a blank one. feel free to fill it out prior to arriving or we will provide you with one.
• Outdoor visits are the preferred type of visit when the weather is nice and temperature can be tolerated.
• We allow indoor visits only in the resident’s bedroom or a common visiting area that can be blocked off to isolate you from any other residents wandering into your space.
• No visitors or tours are allowed to wander the house, or be in the main living room, or dining rooms.
• All visitors will ring the doorbell and be screened at the front entrance.
• Staff will direct you to and the door that is closest to the area in the house that you will be visiting in or the patio.
• All visitors are required to perform hand hygiene or use hand sanitizer at Garden House and wear a clean surgical mask provided by Garden House during visits, regardless of vaccination status.
• The resident will wear a mask as tolerated.
• No visitor is allowed access for a visit with a resident whether in the house or for an outing if the visitor has had known contact with another person who IS POSITIVE or contact with a person or who LIVES WITH someone who has tested positive for Covid-19 within the last month, regardless of whether the person is symptomatic or asymptomatic.
• You should quarantine immediately and notify the Garden House Administrator if you develop symptoms, someone you have had close contact with or someone you live with develops symptoms and then tests positive within 10 days after a visit to Garden House.

Visitation
Indoor & In-Room	Visitation is allowed at all times excepted as specified: Restrictions when resident is in quarantine/isolation: Quarantine – allowed with proper PPE. See Indoor and In-Room Visitation section of PIN 21-40-ASC for additional guidance. Isolation – only essential visits allowed. See Limitation on Visitation of PIN 21-40-ASC for Residents in Isolation; Essential Visits section for additional guidance.
Outdoor	Visitation is allowed at all times.
Initial Screening
Indoor & In-Room	Screened for fever and COVID-19 symptoms.
Outdoor	Screened for fever and COVID-19 symptoms.
Face Mask Requirements
Indoor & In-Room	Well-fitting face mask is required upon entry and at all times within the facility (double mask or surgical mask recommended), regardless of vaccination status.
Outdoor	Well-fitting face mask is encouraged while outdoors where they are around others, including the resident they are visiting, regardless of vaccination status.
Vaccination Verification/Testing See Exceptions to Vaccination, Testing, Verification and Recordkeeping Section of PIN 21-40-ASC for additional guidance.
Indoor & In-Room	Fully Vaccinated Visitor – must provide proof of vaccination Unvaccinated/Incompletely Vaccinated Visitor – must show documentation of a negative COVID-19 test that occurred within 72 hours before each indoor visit and for which the test results are available at the time of entry to the facility. See History of COVID-19 Within the Prior 90 Days of Visit section of PIN 21-40-ASC for additional guidance.
Outdoor	The vaccination verification and testing requirements do not apply to visitors seeking only outdoor visits which do not require entrance to the facility
Physical Distancing
Indoor & In-Room	Physically distance from all other individuals while in the facility, regardless of vaccination status.
Outdoor	Physically distance from all other individuals while in the facility, regardless of vaccination status.
Physical Touch
Indoor & In-Room	Fully Vaccinated Resident and Fully Vaccinated Visitor – may have close contact (including touch) Fully Vaccinated Resident and Unvaccinated/ Incompletely Vaccinated Visitor – resident can choose to have close contact (including touch) If either the visitor or resident is Unvaccinated or Incompletely Vaccinated the safest approach is to maintain at least six (6) feet of physical distancing.
Outdoor	Fully Vaccinated Resident and Fully Vaccinated Visitor – may have close contact (including touch) Fully Vaccinated Resident and Unvaccinated/ Incompletely Vaccinated Visitor – resident can choose to have close contact (including touch) If either the visitor or resident is Unvaccinated or Incompletely Vaccinated the safest approach is to maintain at least six (6) feet of physical distancing.

Family Communication/Visitation Options are:

Outdoor visits pose a lower risk of transmission due to increased space and airflow; therefore, outdoor visitation is preferred.

You must call Garden House at 805-772-7181 to schedule an in person visit. There is no guarantee that a spot will be available. All in person visitors will need to fill out a Screening Form and Questionnaire at the time of your visit. If more than one person is visiting, each individual visitor will need to fill out the Screening Form and Questionnaire.

All visits must be scheduled during designated visiting times. We may not be able to accommodate visitors if an appointment was not made. You will be screened and cannot visit while ill. 

Visiting hours (arrival times will be staggered for safety):

• 11:30am-1:45pm
• 3:30pm-6:15pm

At this time, we can only offer 2 families with a limit of 2 people each inside for visitation at the same time. Designated areas include: Upstairs Living Room with social distancing screen, Resident need not wear a mask; Courtyard or Wonder Garden, Resident need not wear a mask; Resident’s Room (only private rooms have this option and room must allow for 6 foot social distancing unless all parties are vaccinated), Resident must wear mask.

• All visitors must remain in the private visiting area at all times.
• All visitors must use the walkie talkies to communicate to staff that they are ready to leave or need something.
• No visitors are allowed in any common areas during visitation.
• Courtyard patio has a propane heater for warmth, ask the staff to turn it on if you would like.

Taking Your Resident for a Walk or Drive:

Visiting hours (arrival times will be staggered for safety):

• 11:30am-1:45pm
• 3:30pm-6:15pm

• All walks/drives must be scheduled during designated visiting times. No walks/drives will be allowed if an appointment was not made.
• All visitors are encouraged to wear a mask AT ALL TIMES when out for a drive/walk as per CCLD regulations.

Weekly Live Music Wednesdays, 11:30a-12:30p
Held outside when it is warm enough for the residents and not too windy. You may attend if you are LOCAL, symptom-free, properly wear a mask, respect 6 feet of distance from the Residents. Pleas bring your own chair. At this time, the invitation to participate is extended only to immediate responsible parties, vaccinated and unvaccinated. You may not bring guests. Children who cannot maintain social distancing should not attend. We hope that in the future, we will be able to open this up as a community event when we are able to do so safely. Call Garden House on Wednesday mornings after 9:30 to find out if the weather is permitting the outside performance. 805-772-7181

Best Practices for Visitation

Visitors will be asked to reschedule their visit if they are unable to adhere to COVID-19 infection prevention and control measures.

• Limit the number of visitors on the facility premises at any one time to avoid having large groups congregate (based on the size of the building and physical space).
• Increase ventilation or circulation of fresh air as much as possible (e.g., open windows, use fans, etc.).
• Limit visitor movement in the facility. For example, visitors should not walk around different halls of the facility. Rather, visitors should keep at least six (6) feet distance from staff and go directly to and from the designated visitation area.
• Encourage shorter indoor visits and longer outdoor visits.
• Request visitors limit contact with others as much as practicably possible when outside the facility.
• Request visitors be tested as much as practicable.
• A negative test result prior to or at the time of the visit does not preclude a licensee’s responsibility to adhere to infection prevention and control guidelines, including requiring face coverings on visitors and staff and physical distancing, at all times during the visit.
• Visits for residents who share a room should preferably be conducted in a separate indoor space or with the roommate not present in the room.
• Clean and disinfect visitation areas after each visit.

Facetime or Window Visit

CALL GARDEN HOUSE TO ARRANGE: 805-772-7181
Starting times available for a FaceTime or window visit is between 11:30a–1:30p, 3:30p-6:00p and 7:30p-9:30p. 

Window Visit at the large front patio window. We have chairs and 2-way intercoms there so each party can hear each other well. You do not have to wear a mask to have the window visit. When you make the appointment, let the staff know about how long your visit will be. We have chairs and 2-way intercoms there so each party can hear each other well. You must call ahead to schedule a visit since we can only accommodate one family at a time. The intercoms are disinfected between each use. No limit to the amount of people who can do a window visit as long as you are able to socially distance from anyone coming to the front door. 

Facetime (iPhone) or Zoom/Skype (Droid)or Phone Call.

Other Options

Mail cards, letters, and postcards (the old-fashioned way). The Residents LOVE getting mail and it helps connect them to their past since that is how people communicated when they were young.

Send or bring them a gift or flowers homemade treat, card, poster, or collage. You can order ANYTHING online and have it shipped. For gift/clothing ideas, call Rebecca, our nighttime supervisor at Garden House between 8pm and 11pm Sun-Thurs to find out what they might “need.”

In-Person Hospice Visitation

If your loved-one’s status takes a down-turn you will be notified by her and us. If they are bedridden and nearing the end of their life, we have a plan in place for you to be able to visit them in their room. To visit you must be well and show no signs of illness. All in person, non-window visitors will be expected to follow Garden House protocol of a temperature and illness screening, masking, hand hygiene.

Occasionally, a Resident (on hospice or not) has a great day; they eat, participate, and socialize and then unexpectedly pass peacefully in their sleep. We cannot predict how things will go, but we attempt to track their status with our daily charting and staff communication so we can adjust their care plan to meet their (and your) needs.

We encourage you to take advantage of all the options to feel connected.

HERE ARE THE STEPS THAT WE ARE CURRENTLY TAKING IN RESPONSE TO THE COVID-19 OUTBREAK:

• Weekly COVID testing for all non-vaccinated staff. 
• Daily Health Screenings and Hand Washing – Staff, hospice nurses, doctors, and all other people entering the building is screened daily and sent home for any respiratory symptoms, including coughing, sneezing, wheezing, shortness of breath, runny nose, sore throat, or fever. Staff must self-isolate for 7 days after the onset of symptoms AND 72 hours with no fever without the use of fever reducing medication. Everyone entering the building is directed to wash their hands with Hibaclens (surgical soap) for 20 seconds.
• PPE – routine operations are surgical mask (gloves when “hands on” with patients with the addition of gowns when helping patients from bed to chair/toileting/etc.). If staff have or lives with or had close contact with someone who has recently traveled, the wear a KN95 mask for 2 weeks. 
• Sanitized Shoes – Option 1: staff leaves a pair of shoes at Garden House to change into when they arrive at work. Option 2: they take off their shoes when they get to work, Lysol them, and let them dry before putting them back on. 
• Twice Daily Temperature, O2, and Symptom Checking of all of our Residents – we are also continually monitoring residents for symptoms. If any resident(s) develop symptoms we will immediately isolate the symptomatic resident(s) and quarantine the exposed resident(s).
• All staff who assist a Resident with albuterol nebulizer breathing treatments do so in a private room wearing PPE including an N95 mask, gloves, face shield, and gown. We do not perform any other aerosol generating procedures or perform surgery.

HERE ARE ADDITIONAL STEPS OUR STAFF MEMBERS ARE TAKING:

• Monitoring & following CDC, Federal, State & County COVID-19 guidelines, and updating our response plan regularly as new guidelines are issued.
• Our housekeeping staff is increasing our already thorough cleaning protocol. They are cleaning and disinfecting frequently touched objects and surfaces such as counters, doorknobs, phones, etc. twice daily. 
• We are continuing to follow all sanitation and disinfection procedures with environmental cleaning and disinfection with antibacterial cleaners and our UV Cleaning light. All staff change gloves and wash hands between contact with each resident.
• Maintaining hand sanitizer dispensers in various areas throughout our facility.
• Maintaining an appropriate stock of emergency disaster supplies such as food, water, and first aid supplies
• Stocking up on additional PPE (gowns, face shields, N95 masks) in case we have need of them. 
• Staying in contact with our County Office of Emergency Services (which is well-informed and coordinating preparation and response efforts among local agencies), and the SLO County Public Health Department (which is working with all local hospitals regarding implementation procedures according to individual facility policies).
• To stay informed yourself about emergency preparation activities in San Luis Obispo County, visit www.readyslo.org.

We understand that you are concerned about the health and well being of your loved ones. We at Garden House feel like our residents are family and agree with your concern. We continue to work hard to ensure that we are doing everything in our power to keep our residents safe and healthy. Our staff are all self-quarantining as much as possible, only going out for essential services. We feel that we are well prepared for any situation. Please visit our Facebook and Instagram for periodic pictures of your loved ones (gardenhousemorrobay).