Routine inspection·February 9, 2022

At 11:35am Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by the Administrator, who granted access to the facility. LPA explained the reason for the visit. Infection control: LPA reviewed the facility mitigation plan (approved on 03/06/2021) 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. At 11:40am, LPA conducted a tour of the facility with the Administrator and observed the following: Kitchen: 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. Food storage and preparation areas are clean and inaccessible to pests. All knives and sharp objects are locked and inaccessible to residents in care. Medications are centrally stored and locked in the hallway cabinet and inaccessible to residents in care. 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. Continue on LIC809-C Bathrooms: The hot water temperature measured within regulation, at 118.7°F. LPA observed appropriate hand washing signs posted in each bathroom, grab bars and non-skid mat. Outside areas: At approximately, 11:55am 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. Smoke detectors/carbon monoxide . Dual smoke and carbon monoxide detectors were located throughout the facility, and at 12:00pm they were tested and observed to be operational. Laundry service: At approximately 12:20pm, LPA toured through the laundry area (located in a detached garage) and observed cleaning products/chemicals inaccessible to residents. Administrative: LPA collected Certificate of Liability Insurance and LIC.500. Annual fees are current. One staff on duty was hired on November 2, 2021 and had not been fingerprint cleared and/or associated with the facility. Following citations issued for the identified deficiencies pursuant to Title 22 Regulations on LIC809-D. Exit interview conducted, appeal rights discussed and a copy of this report provided to the Administrator.