Routine inspection·October 27, 2021

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Daniela Podar, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA confirmed there are no residents or staff with a confirmed case or signs/symptoms or Covid. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 mask. LPA observed all (6) residents to be in their rooms and (1) resident is on hospice. LPA and Administrator toured the interior of the facility. LPA observed it to be clean, in good repair and to have no foul odors. LPA observed various Covid posters throughout. Rooms toured include (6 private bedrooms, (4) bathrooms, kitchen, laundry/garage and common areas. In the areas toured no immediate health, safety, or personal rights violations were observed. Inside temperature was observed to be 75* F. LPA observed sufficient 2+day perishable and 7+day non-perishable food. LPA observed paper towels, soap and sanitizer, trash can with lid and hand-washing poster in the bathrooms. LPA observed sufficient PPE supply. Administrator stated additional masks are currently on order. Discussed vaccination status of residents and staff. LPA observed fire extinguisher to be serviced last on 8/19/2021. LPA observed required postings at the facility. LPA and Administrator completed the infection control domain and facility was found to be in compliance at this time. LPA requested and obtained updated copy of liability insurance and current Administrator certificate. There were no deficiencies observed during today's inspection. Exit interview. Copy of report provided to facility.