Routine inspection·October 19, 2021

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 10/19/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with facility staff, Iona Tif, 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.. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. LPA requested for facility staff to call and notify Administrator, Silmona Tif, that LPA is present at the facility to conduct an annual inspection. Facility staff called Administrator via telephone. Administrator stated there are no residents at the facility. The facility had relocated residents last year and will remain closed until further notice. LPA toured the interior and exterior of the facility together with Administrator to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, six (6) resident bedrooms, three (3) bathrooms, kitchen, and backyard. LPA observed no residents at the facility. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and facility 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.