Pre-licensing visit·February 2, 2022

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility announced on 2/2/22 to conduct a Pre-licensing referencing 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. Administrator is present at the facility. 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, resident bedrooms, bathroom, kitchen, laundry room, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. Administrator arrived at the facility. LPA, Administrator, and Infection control Leader completed the infection control recommendations and facility was found to be in substantial compliance at this time. Component III review completed. No deficiencies are being cited as a result of todays inspection. This facility has met requirements for licensure. License pending. Exit interview conducted and copy of report left at the facility.