Routine inspection·October 20, 2021

Licensing Program Analyst (LPA) James Sampair conducted an infection control annual inspection and explained the purpose of the visit with Licensee Amy Borja. LPA inspected the facility inside and outside. All of the staff and residents were fully vaccinated. Licensee is the designated Infection control leader. The LPA observed that 3 of the 3 staff present wore face masks at all times. The LPA observed a screening station located near the front entrance with hand sanitizer, a no-touch thermometer, visitor's log, face masks, question concerning and recording of visitor vaccination status for staff, residents, and visitors. LPA observed COVID-19 signs posted in common areas to promote hand washing and physical distancing. Staff documents temperature and health status for staff and residents on a daily basis. The LPA discussed the mitigation plan with the Licensee, as well as their current COVID-19 infection control practices. The Licensee has conducted staff training on infection prevention, symptoms, transmission, as well as the proper donning and doffing of PPE. However, FIT testing has not yet been completed for all of the facility staff members. There were sufficient food and water supplies in the kitchen refrigerators/freezers. Emergency paper and PPE supplies were observed. Facility room temperature was maintained at a comfortable temperature and the hot water was within the safe temperature of 105 to 120 degrees Farenheit. A certified administrator is on site at all times to oversee proper business operation and compliance with COVID-19 infection control practices. Fire extinguishers were observed fully charged and last inspected in May 2021 and the Smoke and Carbon monoxide detectors were fully operational. LPA observed one (1) Type B deficiencies, the details of which are in the LIC809-D citations. Exit interview was conducted and a copy of this report and copies of the Appeal Rights were provided.