Routine inspection·June 23, 2021

Licensing Program Analyst (LPA) Jim August conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into the facility by Caregiver Dolores Milco and explained the reason for the visit. Administrator Normita Vibar arrived shortly after. LPA August toured the facility with Administrator Vibar. There are four clients residing in the facility and no active covid-19 cases. All clients and staff have been vaccinated. All clients appeared clean and well taken care of. LPA observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed had ample soap/ sanitizer and appeared clean. Client bedrooms appeared clean and sanitary and had all required components. Facility is taking client's temperatures daily and documenting results. LPA observed the emergency disaster and evacuation plans, as well as the LIC808 Covid Mitigation Plan. Facility has back-up emergency food and water supply. LPA observed PPE supplies. No citations noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.