Routine inspection·January 25, 2022

At approximately 9:20 AM, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection using the Infection Control Domain. LPA met with Administrator and disclosed the reason for the visit. Census: 4 Entry: Upon entry, LPA observed a ramp in good repair and a sign on the front door indicating cleaning practices, mask requirements, and social distancing. Screening: LPA observed a screening station with 2 boxes of gloves, N95 masks, hand sanitizer, and a thermometer. Administrator screened LPA upon entry. LPA advised Administrator to use a visitor log to document temperature, symptom check, and contact tracing information. Common Area: LPA observed socially distant accommodations in the living room and dining area. Administrator noted residents remain socially distant during meals, and meal times are staggered. Kitchen: LPA observed a locked cabinet below the kitchen with 3 bottles of liquid soap for resident use. LPA suggested a handwashing sign by the kitchen sink. Bedrooms: The facility has 4 bedrooms, of which 1 is shared and 3 are private. The shared bedroom and two private bedrooms are occupied, and one private bedroom is vacant. Bathrooms: The facility has 2 bathrooms. Both bathrooms were clean and contained signs for handwashing instructions. Soap and paper towels are provided for resident use and are stored in a supply cabinet. The bathrooms with the shower contained non-skid mats and grab bars by the toilet and shower. Laundry: LPA observed a laundry are with washer and dryer. Administrator noted the ability to sanitize the machines with bleach after each load. Outdoors: LPA observed a well-maintained outdoor area. All paths were from obstructions. Isolation: In the event of a COVID-positive resident, Administrator is able to isolate the resident in the vacant, private bedroom. All meals and medications would be served by staff with PPE. The facility has adequate PPE and staff are trained on donning and doffing. The facility also has an alternate staffing plan in case of staff shortages. Exit interview conducted and report issued.