Routine inspection·December 6, 2021

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregiver Elizabeth Olbera and explained the reason for the visit. Administrator Cecelia Domingo arrived during the visit. Cecelia Domingo has an administrator certificate expiring 07/11/2022. At 2:00 PM, LPA toured the facility with Administrator Domingo. Facility has six residents in care during today's visit, with three on hospice care. LPA observed residents relaxing in the facility. All residents appeared well taken care of. Facility appears clean and sanitary. All resident's rooms had the required elements as well as restrooms stocked with soap/ sanitizer. Hand washing signs are posted in the restrooms. LPA observed the screening station in the entrance of the facility. Facility screens all visitors to the facility and documents. Facility has covid precaution postings as well as all required department postings. Facility takes resident and staff temps daily and documents. LPA toured the kitchen and observed ample food supply. Facility has completed the mitigation plan and plan has been approved. LPA observed emergency food and water as well as the first aid kit which contained all required items. LPA toured the outside grounds and observed the outside visitation area. Exit gate is unlocked and self latching. Residents participate in activities such as exercise and games. LPA observed the locked medication storage area. Facility has ample supply of PPE and cleaning supplies. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. All staff and most residents are vaccinated for Covid-19. LPA reviewed all resident files which contained all required documentation including emergency information. No deficiencies noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.