Routine inspection·September 3, 2021

Licensing Program Analyst (LPA) Nicole Spencer conducted an unannounced annual inspection focusing on the Infection Control Domain. LPA Spencer was greeted by caregivers in charge and was later assisted by administrator Jennifer Leon and discussed the purpose of today's visit. This single-story home contains five (5) bedrooms, two (2) bathrooms, a living room, kitchen, dining room, backyard, and attached garage. One (1) bedroom is designated as a caregiver's room. The following was observed/inspected: The facility had a universal entrance screening area including a thermometer, hand sanitizer, masks, and sign-in sheet. A temperature check log for staff and residents was maintained daily. COVID-19 signage was placed in several areas including entrance, hallways, and bathrooms. Facility maintained a 30-day supply of PPE. Staff wore face masks throughout their shift and furniture was placed to encourage physical distancing. There was a sufficient supply of 7-day non-perishable foods, but an insufficient supply of 2-day perishable foods including fresh fruits and vegetables. Cleaning solutions and sharps were locked and inaccessible. Water temperature was measured and were within required 105-120 degrees F. All resident rooms contained required furniture including bed, dresser, night stand, lamp and chair. Medications were locked and centrally stored, however, medication administration errors were observed. Smoke detectors/carbon monoxide detectors were present and operable. Indoor passageways were not free from obstruction as a caregiver bed was placed in a common area. A fire extinguisher was observed to be fully charged and last serviced on April 2021. One (1) area of disrepair was observed. An approximately 30 inch hairline crack was located on a resident's bedroom window. ***See 809C for continuation of this narrative*** Client files were inspected and emergency contact information was up to date for three (3) out of four (4) residents. Staff files were inspected and contained required health screenings, criminal record clearances, and trainings. Administrator certificate expires 8/2022. Pursuant to Title 22, deficiencies were cited on the attached 809D. An exit interview was conducted and a copy of this report and appeal rights were provided to the administrator.