Routine inspection·November 29, 2022

On 11/29/2022 Licensing Program Analyst (LPA) Lavinia Muscan, arrived at the facility unannounced to conduct an annual visit using the infection control tool visit. LPA met with Facility Administrator, Motu Sokimi and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured she used hand sanitizer shortly before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. LPA and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, outside area and common restrooms. Facility has a 2 day perishable and a 7 day non-perishable amount of food. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time. Facility has 14 residents 5 of which are on hospice. Additionally, the facility submitted a capacity change for 46 non-ambulatory residents. On 11/23/22 a fire clearance was approved for the change. LPA inspected facility capacity change and approved. Changes will reflect in CCL Licensing System. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.