Routine inspection·August 3, 2023

Licensing Program Analyst (LPA), C. Fowler is conducting an Required-1 Year inspection, on 08/03/23 at approximately 09:30am, and met with Administrator Leonardo Lalim. LPA observed one caregivers on duty during the inspection. Currently six (6) residents in care. Facility has an approved fire clearance four (6) non-ambulatory residents. There are 2 shared rooms and 2 private rooms. The facility has required emergency disaster plan. Facility had an evacuation fire drill on 07/02/23, including staff & residents. Residents, 1 out of 6, has a special diet regarding food and are followed per staff interviews, and per LPA's observations during the inspection. The LPA reviewed two (2) staff files. Administrator certificate for Leonardo Lalim is current-#6062738740, expires 05/03/2024. All staff have required criminal record clearance. All staff have required training. The LPA reviewed four(4) resident files. Resident files were complete. The LPA toured the facility with the Administrator. All exits were unobstructed. The facility fire extinguishers were serviced and tagged as required expires 09/27/2022. Facility had six(8) smoke alarms and carbon monoxide detectors which were working properly when checked during the inspection. Facility had a first aid kit stored in locked kitchen storage, it did have a required first aid booklet. The facility had a sufficient supply of perishable and nonperishable food. Continue on LIC809C The facility had food, water, and emergency supplies to meet the 72 hour shelter in place requirement. The facility had a sufficient supply of personal protective equipment(PPE) for use as needed. The facility had a sufficient supply of hygiene supplies, cleaning supplies, and paper products for use as needed. The LPA observed the facility to be clean and orderly during the visit. The LPA observed that resident rooms, common areas, hallways, and bathrooms had sufficient lighting for residents in care. Residents rooms had required accommodations per regulations. Facility had all medications locked up and inaccessible to residents in care as required. Facility had all cleaners/toxins locked up and inaccessible to residents in care as required. LPA is requesting the following forms be updated and submitted to CCL by 8/11/23: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to provide all information in all boxes as required) Infection Control Plan-if any changes, as discussed Copy of Current Liability Insurance Copy of current Administrator Certificate No deficiencies/citations during today's inspection. Exit interview conducted with the Administrator.