Routine inspection·June 25, 2021

Licensing Program Analyst, (LPA) Jade Jordan conducted an unannounced Inspection Control Annual visit On 06/25/21 . The facility is licensed for six (6) non-ambulatory residents. LPA Jordan and Administrator Elsa Roman toured the physical plant, checked food service, reviewed staff records, resident records, and medication logs. The home consists of 4 resident bedrooms, 2 bathrooms, living room, kitchen, and backyard. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Administrator certificate expires 06/23/22 and has a valid CPR certificate on file. The kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. First Aid kit was available. Outside grounds were toured and no bodies of water was observed. Walkways around the home were clear and free of hazards. The home has a detached garage used for storage . It is inaccessible to residents in care. The Last fire drill was conducted in March of 2021. LPA observed staff wearing masks, Visitor Log /Symptom screening Log, Designated isolation room, required Covid-19,Postings, 30 day supply of PPE and other required documents, including phone numbers are posting as mandated by the DPH and CCLD. No citations were issued during visit, a copy of this report was provided to Administrator.