Routine inspection·August 5, 2022

On 8/5/22 at 2:10 PM, Licensing Program Analysts (LPAs) K. Nguyen and L. Francisco arrived unannounced to conduct Infection Control Inspection. LPAs met with Direct Support Professional, Lucky Amenaghawon, and explained the purpose of the visit. Joseph Farrish Administrator later arrived at 2:42pm during the visit. LPA continued the inspection with Joseph. During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient of non-perishable food supply. There is one central entry point for universal screening for staff, residents, and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 8/12/2022: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610D Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate Exit interview conducted. A copy of this report is provided