Routine inspection·June 23, 2021

Licensing Program Analyst (LPA) Wolter arrived at the facility unannounced on 06/23/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPA met with administrator, Rodney Fleeman and explained the purpose of the visit. Prior to initiating the annual inspection, 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 and contacted facility and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask. Additionally, LPA utilized facility visitor sign in sheet with temperature screening upon entry. 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, brief inspection of four (4) resident bedrooms, four (4) bathrooms and shower rooms, laundry room, and outdoor area. In the areas toured LPA observed cleaning supplies under the kitchen sink were unlocked and accessible, knives in kitchen cupboard were unlocked and accessible, and bleach was unlocked and accessible in the laundry room. LPA and administrator completed the infection control domain and facility was found to be in substantial compliance at this time. Deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report and appeal rights to be sent to administrator. Administrator to send in updated copy of LIC 500 - Personnel Report, and current copy of Liability Insurance to Community Care Licensing by 07/02/2021.