Follow-up on corrections·February 3, 2023

Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced for case management. LPA explained the reason for the visit and requested staff contact AD. LPA was met by caregiver S1 who greeted and allowed entry into the facility. Caregiver S2 contact Administrated (AD) and completed tour with LPA. AD arrived later. S2 stated there are currently 5 residents at the facility. LPA observed all residents in their rooms. One room was shared by 2 males residents, another room is waiting for the arrival of a new resident, another room had one resident asleep, and the last room was shared by two female residents. During the tour of the facility LPA observed the cabinet under the sink had a broken lock. Cabinet contained cleaning supplies/chemicals. LPA explained chemicals must remain locked at all times and this is a deficiency. LPA also observed scissor on the counter top and knives left unlocked. LPA did observe caregivers preparing lunch and reminded caregivers to keep all sharps locked and inaccessible to residents. Due to the circumstance no discrepancies were found for the sharps. An exit interview was conducted, and a copy of this report, LIC809D, and appeal rights were left with AD Susan Baal, whose signature on this form confirm receipt of these documents. Due to LPA having issues with the printer LIC809, LIC809D, and appeal rights sent by email.