Routine inspection·February 22, 2022

At approximately 2:50 PM on 02/22/22, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with staff and disclosed the reason for the visit. Census: 3 Entry: The facility was surrounded by a locked gate which was controlled by remote. The facility used surveillance cameras inside and outside. The front yard was well maintained. Screening: LPA was screened upon entry for temperature, but not symptoms. LPA recorded temperature and contact tracing information in a visitor log. LPA advised Administrator to screen visitors for symptoms of COVID-19. Bedrooms: The facility had 3 bedrooms. All bedrooms were designated for ambulatory residents. Bedroom #1, near the rear of the facility, had a non-ambulatory resident. Bedroom #2 was a shared bedroom with beds at least 6 feet apart to maintain physical distance. Bedroom #3 was also shared but unoccupied. All bedrooms contained adequate linens, storage space, nightstands, and lamps. All window screens were in good condition. Bathrooms: The facility had 2 bathrooms. Bathroom #1 had liquid soap, paper towels, a handwashing instruction sign, a trash can with a tight-fitting lid, grab bars in the tub and toilet, and a non-skid mat. The knob for the sink faucet would not adjust water temperature. LPA could not test for hot water. LPA observed medicine below the sink and behind the mirror. Bathroom #2 had liquid soap, a handwashing instruction sign, and grab bars in the tub. There was a mount for grab bar near the toilet, but no grab bar. LPA tested water temperature at 126.8 degrees Fahrenheit. Common areas: LPA observed common areas to be organized, clean, and free from hazards. A metal grate covered a fireplace by the front entrance. LPA tested the smoke detector which was in good operation. Emergency Exit plans with routes clearly labeled were hung in the living room and resident bedrooms. LPA observed a fully-charged fire extinguisher hung near the kitchen. LPA also observed signs for resident rights, house rules, and a confidential complaint hotline. A staff bed was set up between the living room and the emergency exit. Kitchen: LPA observed a dining table and a kitchen in good condition. All sharps and hazards were locked in cabinets. The facility had a sign pertaining to COVID-19 practices. Outdoor area: LPA observed all exit routes to be free from hazards and obstructions. LPA observed 3 sheds outside. Two unlocked sheds contained incontinence supplies and patio furniture in good repair. A locked shed contained tools. LPA also observed a shaded swinging bench. Due to the Administrator’s absence and staff’s limited English, LPA will return on a later date for a Continuation visit. LPA conducted exit interview, issued deficiencies, discussed appeal rights, and issued report.