Routine inspection·May 12, 2021

Licensing Program Analysts (LPAs) Wolter and Leitzell arrived at the facility unannounced on 05/12/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPAs met with staff, David Magda and explained the purpose of the visit. Prior to initiating the annual inspection, LPAs completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and contacted licensee and completed a facility risk assessment. LPAs ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Masks. Additionally, LPAs were screened by facility staff upon entering the facility. LPAs and staff toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, two (2) resident bedrooms, two (2) bathrooms, kitchen, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and staff completed the infection control domain and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility. Staff to send in updated copy of LIC 308 - Designation of Facility Responsibility and current copy of Liability Insurance to Community Care Licensing by 05/19/2021.