Routine inspection·October 19, 2022

Licensing Program Analyst (LPA) Jill Nakagawa arrived at Three Home Village II for the purpose of conducting an unannounced Required-1 year inspection. LPA was met at the door by carestaff, who performed a Covid-19 test on LPA and granted LPA access into the home. Testing is done prior to entrance for all visitors as a precaution. LPA toured the facility with licensee, Erik Flatt. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Exits were equipped with auditory devices. 3 Fire Extinguishers were found to be last charged on 9/1/2022. Smoke detectors and carbon monoxide detectors were found to be operational during the visit. Hot water temperature measured between 105 and 110 degrees F. The facility tests the water each day for variations in temperature. The facility serves residents with dementia and has a plan of operation for special care and programming. There was a sufficient supply of both perishable and nonperishable food as required by Title 22 Regulations. Toxins are stored under kitchen sink cabinet and small living room closet. There was a supply of cleaners, hygiene products and paper products available for residents. The bathrooms designated for residents at the facility were supplied with individual paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. All bedrooms have lighting & appropriate furnishings. The outdoors of the facility provided attractive and easily accessible garden and visiting areas for residents and their visitors, which is especially beneficial for social distancing. Facility has PPE supply stored in the storage sheds in back yard. Staff have had all PPE training required. Facility is N95 Fit tested. Disaster drills were conducted on 9/16/2022Covid-19 Mitigation Plan and Infection Control Plan were submitted. No deficiencies were observed or cited during today's Required 1- Year inspection. Exit interview was conducted with Licensee, Erik Flatt.