Routine inspection·October 12, 2021

Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in order to conduct a Required 1 year Infection Control Annual. LPA was greeted by facility staff and had his temperature taken and was asked COVID -19 related questions. The administrator arrived a short while later. A tour of the physical plant was conducted. The facility has four (4) bedrooms and two (2) bathrooms currently occupying three (3) residents. One (1) bathroom is designated for staff use. The facility is fire cleared for six (6) non-ambulatory residents, one of which maybe bedridden on room #2 or #3. Hospice waiver for two (2) residents. There is a pool, which was observed to be locked with a 5 foot gate around the pool. The home was also checked for fire safety. The smoke alarms and carbon monoxide detectors are hardwired and were tested to be functional. The facility is following their mitigation plan and all of the COVID -19 protocols. No deficiencies were cited during the visit. Exit interview conducted and report issued.