Routine inspection·February 17, 2023

At approximately 10:55AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Executive Director, Angie Boucher-Turin. The visit is focused on the Infection and Control Practices of this facility. Upon arrival at the facility, LPA had their temperature checked and logged. LPA answered a standard COVID-symptom questionnaire. LPA conducted a walk-through of the facility and observed the following: COVID-19 signs were observed at the entry way and throughout the facility. Hand-washing signs were observed in the bathrooms and at sinks. All staff present were observed to be wearing a mask. The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility has a cleaning and disinfecting schedule that occurs twice per day. Facility has at least a 30-day supply of Personal Protective Equipment (PPE) and medication for Residents. Staff and Residents are screened daily for COVID-19 symptoms and it is logged into facility binders. LPA and Administrator discussed the following: Covid and Influenza A Protocols Staffing Resources and Staff Training Incident/Death Reports and Reporting Requirements Annual Inspection Expectations Facility has a plan in place if a staffing shortage were to occur. Facility has submitted their Mitigation/Infection Control Plan to Community Care Licensing (CCL). Continued on LIC-809C Continued from LIC809 Facility has a Central Pull Fire Alarm system that is directly connected to the Fire Department. Fire extinguishers were last serviced December 2022. Per facility inspection records, smoke detectors and fire alarms were last tested in July 2022. Elevators were last inspected on 3/9/2022. The last facility fire and evacuation drill was conducted in January 2023. LPA requested the following documents to update facility file: Administrative Organization (LIC 309) Affidavit regarding Client/Resident Cash Resources (LIC 400) Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Personnel Report (LIC 500) Surety Bond (LIC 402) Register of Clients/Residents (LIC 9020) Updated Liability Insurance Active and Current Administrator Certificate Documents to be submitted to Community Care Licensing (CCL) by Friday, 3/10/2023. No Deficiencies Cited during visit. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.