Routine inspection·May 16, 2022

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 5/16/22 to conduct a Annual Inspection utilizing the infection control domain. LPA met with staff and explained the purpose of the visit. Prior to initiating the annual inspection, LPA 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. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: n-95 mask. Additionally, LPA were screened by facility staff upon entering the facility. LPA requested for staff to notify Administrator that LPA is present at the facility to conduct an annual inspection. Administrator was unable to attend. LPA toured the interior and exterior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, 6 resident bedrooms, 3 bathroom, kitchen, laundry room, and backyard. LPA and caregiver completed the infection control domain. LPA measured the water temperature in the residents' bathroom/ shower to be 124 degrees F. Temperature was adjusted while LPA present. LPA found cleaning supplies unsecured in the garage and advised that the cabinets with locks be utilized. LPA advised that records or daily symptom screening of residents and staff as well as weekly testing of staff not vaccinated and boosted be maintained and available at the facility. LPA requested that the following records be submitted: Liability Insurance declaration, Resident roster, staff roster, proof of screening, covid testing (if applicable) and LIC 308. As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care. Exit interview conducted and copy of report and appeal rights left at the facility.