Routine inspection·June 25, 2021

On 06/25/21 at 1:30PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an infection control annual inspection and explained the purpose of the visit with house manager. LPA spoke with administrator on the phone who authorized the house manager to sign the reports. Facility has a completed mitigation plan in place dated 03/04/21 to mitigate the spread of COVID-19. LPA discussed the completed mitigation plan (LIC 808) with house manager as well as COVID-19 infection control practices. LPA inspected the facility inside and outside. LPA observed a screening station located near the front entrance with visitor's log, hand sanitizer, gloves, face masks, no touch temperature probe. Routine symptom screening (+/-) temperature and symptom check) is done at entry for all staff, residents and visitors. LPA observed COVID-19 signages posted in common areas to promote hand washing, cough/sneeze etiquette and physical distancing. Facility documents daily temperatures and COVID-19 symptom checks for staff and residents. Pathways were observed to be free of obstruction and fire hazards. A written emergency/disaster plan was observed last updated on 05/21/21. Continued on next page LIC 809-C Infection control designated leader is the administrator. All staff and residents have been fully vaccinated since March 2021.There was at least 7 days of nonperishable and 2 days of perishable foods. Emergency food supplies were observed stored in the garage. Facility room temperature was maintained at 73 degrees Fahrenheit. Medications were observed locked in the dining cabinet. Toxic chemicals were observed locked in the bathroom closet. A certified administrator is on site a minimum of 20 hours a week to oversee proper business operation and compliance with COVID-19 infection control practices. Fire extinguisher was observed fully charged and last inspected on 06/20/21. Smoke and Carbon monoxide detectors were operational. Updated copies of the following documents were requested to be emailed to LPA on 06/28/21: · LIC500- Personnel Report · LIC308- Designation of Facility Responsibility · LIC610E- Emergency/Disaster Plan · Evidence of Liability Insurance No deficiencies were observed during the infection control annual inspection. Exit interview conducted and a copy of this report provided.