Routine inspection·October 27, 2021

Licensing Program Analyst (LPA) Martessa Brown conducted an unannounced Annual required visit with a primary focus on infection control measures. LPA was met by Marylou Namoc, the administrator and the purpose of today’s visit was explained. The facility is licensed to serve residents 60 and over, 6 non-ambulatory and 1 may be bedridden. There are currently (6) non-ambulatory resident and all of them appeared to be well. The facility is a single story structure located in a residential neighborhood. It consists of the following: 5 bedrooms, 2 bathrooms, living room/dining room, kitchen and shaded patio area, laundry room was located the attached garage. LPA and administrator toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were clean and in good condition, adequate lighting provided, storage for residents personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured in #1 at 109.5 and #2 111.7. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is a enough perishable and non-perishable food available which is stored properly. Fire extinguisher was charged, smoke detectors and Carbon Monoxide were operable. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations ( Located in common areas and restrooms). LPA observed staff and residents were wearing face coverings, an isolation room and required postings throughout the facility. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LIC 809-C is on the next page. LPA advised the Administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. During today’s visit there were no deficiencies observed. Exit interview held. A copy of the report was provided to the Administrator.