Routine inspection·July 27, 2022

On 07/27/22 at 2:40PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced infection control annual inspection and explained the purpose of the visit with administrator. LPA observed 3 staff wearing N95 face masks and 3 residents watching TV with social distancing sitting in the living room during visit. Facility has a mitigation plan in place to mitigate the spread of COVID-19. LPA discussed the completed mitigation plan (LIC 808) with administrator as well as COVID-19 infection control practices. LPA inspected the facility inside and outside. One central entry point has been designated for universal entry screening with the station located near the front entrance with visitor's log, hand sanitizer, gloves, face masks and no touch temperature probe. COVID-19 signs are posted throughout the facility 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 binder was observed located near a Lan line phone in the kitchen. Centrally stored medications were locked in kitchen cabinets. Sharp objects were locked in the kitchen drawers. Toxic chemicals were locked in the garage. Continued on next page LIC 809-C Infection control designated 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. Facility room temperature was maintained at 74 degrees Fahrenheit. Common areas and bathrooms have COVID-19 signages. Administrator is on site to oversee proper business operation and compliance with COVID-19 infection control practices. Fire extinguisher was observed fully charged. Smoke and Carbon monoxide detectors were operational. Adequate supplies of PPE were also observed stored in the hallway cabinet and storage shed. Facility follows daily cleaning, sanitation of frequently touched common surfaces using Clorox and Lysol disinfectants. Updated copies of the following documents were requested for facility file and are to be submitted to CCL on or before 07/28/22: · LIC500- Personnel Report · LIC308- Designation of Facility Responsibility · LIC610E- Emergency/Disaster Plan with COVID infection Plan · Evidence of Liability Insurance No deficiencies cited during this visit. Exit interview conducted and a copy of this report provided