Routine inspection·October 13, 2021

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Placida "Bing" De Vera and Jocelyn Streeter, caregivers, and explained purpose of inspection. LPA was screened LPA upon entrance. Caregiver Bing contacted Administrator, Scott Afable, by phone, who arrrived at approximately 11:30 am. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, 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 ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask. LPA confirmed there are (4) residents currently at the facility and (1) resident is currently at the hospital. LPA and caregiver toured the interior of the facility and observed it to be clean and in good repair. LPA observed all (4) residents to be in their room resting. Rooms toured include (5) private bedrooms and (1) vacant room, (2) bathrooms, kitchen and common areas. 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 compliance at this time. Inside temperature was observed to be 75* F. Fire extinguisher last serviced 5/16/2021. LPA observed sufficient 2+day perishable and 7+day non-perishable food on site. LPA observed paper towels, soap and sanitizer in the bathrooms. LPA discussed and obtained recent paperwork for a resident who had an appointment on Monday, 10/11/2021. All staff are associated or requested to be associated previously- Admin showed LPA verification- request was resent today. There were no deficiencies observed during today's inspection. Exit interview. Copy of report to be emailed to Administrator following inspection.