Routine inspection·October 28, 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 Administrator Grace Radford and explained the reason for the visit. Administrator Grace Radford has an administrator certificate expiring on 1/28/2022. At 1:45 PM, LPA toured the facility with Administrator Radford. Facility has six residents in care during today's visit, with one 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 throughout the restrooms. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility takes resident and staff temperatures daily and documents. Facility has covid precaution postings as well as all required department postings. 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 as well as a fenced and secured pool. Exit gates are unlocked and self latching. Residents participate in activities such as exercise, games, and drives in the community. 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 residents are vaccinated for Covid-19. LPA reviewed all files which contained all required documentation including emergency information and updated physician reports LPA consulted with Administrator regarding the importance of maintaining an ample supply of N95 masks on-site at all times. Additionally, Administrator was advised to post the "Let Us No" poster in regulation size, 20' X 26." No deficiencies noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.