Routine inspection·July 29, 2021

Licensing Program Analyst (LPA) Jennifer Jones conducted an unannounced annual random visit and met with Licensee Birdie King and Administrator, Narkell Hobbs James. The facility is a well landscaped one story house which is licensed for 6 ambulatory residents. There is currently six residents residing in the facility. LPA toured the physical plant, checked food service, reviewed staff files, reviewed resident files for medical status and reviewed medications. The facility conducted last fire drill 01/2021. The home consists of 3 resident bedrooms, 1 1/2 bathrooms, laundry area, living room, dining room, and kitchen. The facility has an additional area located in the back of the house for staff use with two additional bedrooms, one bathroom, den and office. Resident bedrooms had the required furniture, and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mats were in place, water temperature properly measured at 105 F in bathroom. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Outdoor shaded patio area was accessible to residents. There are no security bars or weapons on the premises. Cont page 2 During the visit, LPA observed the facility infection control practices. LPA observed a screening station with sanitizer in the facility and additional sanitation/PPE supplies in the staff office inaccessible to the residents. LPA observed a sign in sheet and temperature log for visitors. The administrator checked LPA's temperature upon entry. LPA observed staff wearing mask. The facility has an isolation room for residents and required postings are throughout the facility. The administrator advised LPA that visitors have the option to meet with the residents inside or outside. No deficiencies cited: Exit interview conducted and a copy of report was given to the administrator