Routine inspection·February 11, 2022

At 10:00am Licensing Program Analyst (LPA) Angela Panushkina, conducted an unannounced annual inspection at the above facility. LPA met with the Staff #1, who granted access to home. Administrator arrived shortly after and LPA explained the reason for the visit. LPA toured the entire facility with the Administrator, and observed the following: This is a 5 bedroom, 2 bathroom, single story family residence that includes a living room, dining area, kitchen, laundry room and attached garage. Infection control: Upon arrival LPA did not observe a screening area, was not screened by S #1 and was not asked any infection control questions. The screening log was not available and LPA had to prompt and guide staff through the screening process. Administrator stated they have sufficient PPE supplies for residents and staff. Kitchen: At approximately, 10:34am LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. Smoke detectors/carbon monoxide . Dual smoke and carbon monoxide detectors were located throughout the facility, and at 11:05am they were tested and observed to be operational. Bedrooms: There are four (4) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Bathrooms: At 10:50am LPA observed all bathrooms are clean and in good repair. The hot water temperature Continue on LIC809-C measured at 105°F. LPA observed appropriate grab bar and non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination. Common Areas : The facility maintains a comfortable temperature at 71°F. The living room and dining area appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. There is a fire extinguisher by the kitchen and it was last serviced on 04/15//21. Laundry area was located in a hallway and all chemicals observed to be locked and inaccessible to residents. Outside areas: At approximately, 11:00am LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water. The garage: LPA observed attached garage that is used for storage and kept locked and inaccessible to residents. Medications: At approximately, 10:50am LPA observed medications are centrally stored and locked in the cabinet, by the dining area and inaccessible to residents in care. Administrative: Administrator will email a copy of Liability Insurance and LIC.500. Deficiencies issued per Title 22. Appeal rights issued. Exit interview conducted. Copy of this report emailed to Licensee.