Routine inspection·February 9, 2022

At 09:30am Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by Staff #1, who granted access to the facility. The Administrator arrived shortly after and LPA explained the reason for the visit. At 9:38am, LPA conducted a tour of the facility and the following was observed: Infection control: LPA reviewed the facility mitigation plan (approved on 02/11/2021) to make sure licensee was following current infection control recommendations. Upon arrival, LPA was screened and asked to sign-in the visitors’ log. In addition, LPA was asked all infection control questions. Proper signage was observed inside along the hallway and in the restrooms. Hand sanitizer was also observed. Administrator stated they have sufficient PPE supplies for residents and staff. LPA observed all trash can throughout the facility have fitted lids. Kitchen: At approximately, 09:38am 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 10:10am 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. Auditory alarms were tested and observed to be operational. Bathrooms: At 10:00am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. The hot water temperature measured at 115.7°F. LPA observed Continue on LIC809-C 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 76°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 area and it was last serviced on 06/29/21. Outside areas: At approximately, 10:25am 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: Laundry area is located in an attached garage and kept locked and inaccessible to residents. Extra PPE supplies and food storage was also observed. Medications: At approximately, 09:45am LPA observed medications are centrally stored and locked in the closet, by the kitchen area and inaccessible to residents in care. Administrative: LPA collected Certificate of Liability Insurance and LIC.500. No citations issued during this visit. Exit interview conducted. Copy of report emailed to Licensee.