Routine inspection·October 19, 2021

Licensing Program Analyst (LPA) Vasallo conducted an annual required visit. LPA met with Administrator, Linda Renard and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the physical plant, COVID-19 procedures, reviewed residents' medications, observed food supply, and reviewed resident and staff files. Facility has submitted a mitigation plan and the plan has been approved. All 4 resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. There is a carbon monoxide in the hallway. Both bathrooms were toured. Bathrooms have the required grabs bars and non-skid mats. The hot water was 110.1 degrees which is within the required 105 - 120 degrees. The kitchen was toured. All appliances were operating properly. There was sufficient perishable food in the kitchen and garage refrigerators. There were a variety of foods including meats, vegetables, and fruit. There was also sufficient non-perishable food. The common areas including the living room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. LPA reviewed 5 resident files. Files were complete and included appraisals, physician's reports, medical consent, personal inventory forms. LPA also reviewed 2 staff files to confirm health screenings, fingerprint clearances and training. LPA reviewed residents' medications. Medications are documented properly and given as prescribed. There was a technical advisory given to the facility for failure to assess LPA at the point of entry. This is a requirement per COVID-19 procedures. There were no deficiencies documented. Exit interview held and a copy of the report and technical advisory were provided.