Routine inspection·January 31, 2023

On 01/31/2023 at 2:35PM Licensing Program Analyst (LPA) L. Ibo conducted an infection control annual inspection and explained the purpose of the visit with S2. LPA called Administrator Kavitha Pramod and back up Administrator Pramod Balanandan and informed them the purpose of the visit. Administrator arrived around 3:37PM. LPA observed 2 staff wearing face masks and 5 residents. Facility has 4 hospices during the visit. 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. Continued on next page, LIC 809-C Facility documents daily temperatures and COVID-19 symptom checks for staff, visitors, and residents. Pathways were observed to be free of obstruction and fire hazards. Adequate supplies of PPE were observed stored in the backyard shed. Facility follows daily cleaning, sanitation of frequently touched common surfaces using Clorox and Lysol disinfectants. Administrator, the designated infection control leader and is on site at least 20 hours a week 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. Updated copies of the following documents were requested for facility file and are to be submitted to CCL on or before 2/15/2023: · LIC500- Updated Personnel Report · LIC308- Designation of Facility Responsibility · LIC610E- Emergency/Disaster Plan/Infection Control Plans · Evidence of Liability Insurance No deficiencies cited during this visit. Exit interview conducted and a copy of this report provided.