Routine inspection·June 16, 2021

On 06/16/21 at 2:30 PM, Licensing Program Analyst (LPA) conducted an infection control annual inspection and explained the purpose of the visit with administrator. LPA observed 1 staff wearing face mask during visit. LPA observed no residents living at the facility. Administrator stated they wanted to keep the license and has continued to pay the annual fees on time. LPA observed one central entry point designated for universal entry screening at the main entrance. LPA observed screening station located near the front entrance with visitor's log, hand sanitizer, gloves, face masks and no touch temperature probe. Per staff, the designated infection control leader is the administrator. LPA observed COVID-19 signages in common areas. Facility has a completed mitigation plan in place dated 01/24/21 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. Administrator is the designated infection control leader. LPA observed locked medication cabinets in the kitchen and locked toxic chemical cabinets located inside the laundry area. Adequate PPE supplies were observed stored in the garage. All staff have been fully vaccinated since January 2021. Continued on next page LIC 809-C 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 72 degrees Fahrenheit. Fire extinguisher was observed fully charged. Smoke and Carbon monoxide detectors were operational. A written Emergency/Disaster plan dated 06/06/20 was observed posted in the kitchen area. Sharp objects were locked underneath the kitchen sink. Updated copies of the following documents were requested for facility file and are to be emailed to LPA by 06/16/21: · LIC500- Personnel Report · LIC308- Designation of Facility Responsibility · LIC610E- Emergency/Disaster Plan · Evidence of Liability Insurance No deficiencies cited during this visit. Exit interview conducted and a copy of this report provided to administrator.