Routine inspection·February 24, 2022

Licensing Program Analyst (LPA) Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and met with Administrator/Licensee Leslie Wilson. There are 3 residents with no resident under hospice at this time. LPA arrived at the facility and had her temperature checked and logged into a log. During facility tour on 2/24/2022 with administrator; facility was found to be at a comfortable temperature. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 2/2022 at the time of the visit. Sample test of Smoke Detectors & Carbon monoxide detector were found to be operational during this visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored and locked under the kitchen sink and garage. Dangerous items were stored inaccessible to clients. There was a supply of cleaners, hygiene products and paper products available for clients. All resident’s bedrooms have lighting & appropriate furnishings. Facility licensee understands that disaster drills must be conducted at least quarterly and records should be available for the Department to review. Infection Control: Facility has submitted a mitigation program plan that has been approved. Posters have been placed throughout of the facility. Facility has hand sanitizer available; visitors and staff before coming into work and temperature is checked and logged in a visitor clip board. Continue LIC 809-C Facility has PPE supply stored in dining room. There has been no new staff hired, however; new residents have been admitted since COVID. Residents’ medications are stored and locked in the medication file cabinet by the kitchen. Facility has a 30-day supply of medication for clients. Residents are not wearing masks inside the facility, however; staff stated that they are able to wear masks when going on outings. All staff had masks on during this visit. In addition, facility has a designated area for visitors which are being allowed. Residents have also available telephone calls when contacting with family members and others. Staff have had all PPE training required on file and still working towards the required N-95 fit testing for staff. There were no deficiencies cited at this time. Department is requesting facility to submit the following updated documents by 3/3/2022: LIC 308 Designated LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 610E-S Supplemental Emergency Disaster Plan for RCFE LIC 9020 Register of Facility Client’s/Resident’s Copy of Certificate of Liability Insurance Copy of Administrator Certificate