Routine inspection·June 28, 2021

On 06/28/21 at 1PM, Licensing Program Analyst (LPA) conducted an infection control annual inspection and explained the purpose of the visit with house manager. LPA observed administrator was not available during visit. LPA spoke with Administrator on the phone who authorized the house manager to sign the reports. LPA observed one central entry point designated for universal entry screening at the main entrance. LPA observed no visitors' log at the screening station for recording temperature logs for residents, staff and visitors. House manager agreed to document routine symptom checks daily in a visitor's log for residents, staff and visitors. LPA observed S1 and S2 were wearing face masks during visit. Facility has a completed mitigation plan in place dated 06/01/2021 to mitigate the spread of COVID-19. LPA discussed the completed mitigation plan (LIC 808) with staff as well as COVID-19 infection control practices. LPA inspected the facility inside and outside. Pathways were observed free of obstruction and fire hazards. Per staff, the designated infection control leader is the administrator. All staff and residents have been fully vaccinated since February 2021. There was at least 7 days of nonperishable and 2 days of perishable foods. Emergency food supplies were observed stored in the garage. Continued on next page, LIC 809-C Facility room temperature was maintained at 75 degrees Fahrenheit. Smoke and Carbon monoxide detectors were operational. Centrally stored medications were locked in dining room cabinets. Toxic chemicals were locked in the garage. Sharps were observed locked underneath the kitchen sink. Fire extinguisher was observed fully charged and last inspected on 10/20/20. A written Emergency/Disaster plan dated 01/01/2020 was displayed in the kitchen area. Updated copies of the following documents were requested for facility file and are to be submitted to CCL on or before 07/07/21: · LIC500- Personnel Report · LIC308- Designation of Facility Responsibility · LIC610E- Emergency/Disaster Plan · Evidence of Liability Insurance No deficiencies were cited during this visit. Exit interview conducted and a copy of this report provided.