Routine inspection·March 29, 2022

Licensing Program Analyst (LPA) Katie Brown arrived at the facility unannounced to conduct the Annual Infection Control Inspection. LPA met with Administrator Kristina Socias. LPA entered through the central entry point where Health Screening and temperature was taken. Hand sanitizer was observed at entry. Infection control procedures which were observed or reviewed by LPA include: Daily symptoms screenings (for staff, residents and visitors), testing, visitation requirements , quarantine/isolation procedures, staffing, PPE and daily infection control procedures. All 3 residents are fully vaccinated. LPA toured the facility inside and out. Required postings as well as Covid-19 and hand washing signs were observed. Furniture in common and dining areas are spaced to promote distancing. Facility has designated visitation areas available. LPA observed 30-day resident medication, adequate food storage and PPE. Bathroom sinks are stocked with liquid soap and paper towels. No deficiencies cited during today’s visit. A copy of this report will be provided via email to noble.servant.homes@gmail.com. An exit interview was conducted with the Administrator. LPA requested the following updated forms by 4/5/22: LIC 308, LIC 500, LIC 610E, LIC 9020 and a copy of current Liability Coverage.