Routine inspection·June 11, 2021

Licensing Program Analyst (LPA) Wolter arrived at the facility unannounced on 06/11/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPA met with administrator, Nelson Jacinto 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. LPA and administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, main building- including two (2) shared resident bedrooms, second house- including one (1) shared resident bedroom, shower rooms, and outdoor area in the areas toured no immediate health, safety, or personal rights violations were observed. LPA and administrator 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. Administrator to send the department a copy of current liability insurance, LIC 308 - Designation of Facility Responsibility, LIC 500 - Personnel Summary by 06/18/2021.