Routine inspection·February 28, 2022

Licensing Program Analyst (LPA) Jose Villalobos made an unannounced Annual inspection focused on Infection Control. On today’s visit LPA met with Administrator Vilma Bohanan and the purpose of the visit was discussed. As a part of the inspection, LPA used the inspection tool, reviewed (4) resident records, (2) staff files, and (4) resident medications. Currently the facility has (6) residents which are non-ambulatory. The two-story residential house consists of (4) resident bedrooms, (2) resident bathroom, living room, dining room, kitchen, 2nd floor is staff living quarters, covered patio with table and chairs, and a detached garage. Front and back yard is in good condition at time of visit. Washer/Dryer appliances observed. Toxins and sharps locked and inaccessible to clients. Bedrooms #1-#2 are equipped with two beds, a dresser, lamp, chair, overhead lightning and closet space. Bedrooms #3 and #4 are single resident rooms with the required furniture as well. Bathrooms have a working toilet, wash basin, and showers. Beds have the required linen/supplies which include, pillowcase, mattress padding, fitted sheet, blanket and bedspreads. Supply of hygiene supplies stored for each resident observed. Fire alarms are interconnected and operational. Required postings observed. There is (1) fire places blocked off from use. Backyard pool is gated and inaccessible to residents. Water temperature within required tittle 22 regulations. Infection control domain completed and there were no deficiencies. An exit interview was conducted. Copy of this report provided Administrator Vilma Bohanan.