Routine inspection·October 13, 2022

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus of the infection control domain. LPA met with the Administrator, Greg Tillman. The purpose of the visit was explained. The facility is approved for 15 residents, ages 60 and over, of which 15 may be non-ambulatory. This facility has a total of 10 bedrooms and 3 communal bathrooms downstairs. Rooms #1 - #6 are either single or shared rooms and Rooms #7 - #10 are all single bedrooms with a private bathroom. The Administrator's office is on the second floor. LPA toured the facility, interviewed 3 Staff, and 2 Residents. The following were inspected/observed: * Signage are posted by the front entrance and throughout the facility to promote hand washing, cough etiquette, and social distancing. * Table is set up by the entrance where the visitor sign in, screened, and temperature taken. Masks and hand sanitizers are readily available. * There are vacant rooms which can be utilized as isolation rooms for COVID-19 positive residents. * Extra supplies of PPE such as N95 masks, hand sanitizers, and gowns are stored in the garage. * Disinfectant and cleaning supplies are stored and locked under the kitchen sink. Extra supplies are stored in the supply closet. * There are adequate food supplies of 2 day perishable and a week of non-perishable observed. * Reviewed medications for 4 residents and medications are being given as prescribed. * LPA reviewed 3 Staff files and 4 Resident files today. Staff #1, #2, and #3 files did not have current First aid training certificates. A deficiency is cited on the LIC809D. An exit interview was conducted and a copy of this report along with appeal rights were provided to the Administrator.