Routine inspection·June 30, 2022

On 6/30/2022, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required annual. LPA met with Caregiver, Hope Smith, who contacted Administrator, Maria Custura, who arrived shortly to the facility. LPA explained purpose of inspection to Administrator. Before today's inspection, LPA completed required COVID-19 testing protocols and completed daily assessment and confirmed the facility does not currently have any positive Covid-19 diagnoses. LPA was screened per Covid-19 precautionary measures upon entering the facility. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. The facility is licensed for (6) residents and has a hospice waiver for (4). There are (5) residents in the facility and no resident on hospice. LPA and Administrator toured the interior and exterior of the facility and there were no safety risk or personal rights violation. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, and backyard. LPA observed hand washing signs, paper towels and soap present in the restrooms. LPA advised Administrator that all trash can should have lids. LPA observed the Ombudsman and CCLD poster at entrance of the facility. Fire extinguishers last serviced 6/17/2022. LPA observed the facility to have good documentation of staff and residents daily temperature screening. LPA and Administrator followed the infection control domain guidelines and facility was found to be in substantial compliance at this time. LPA observed all staff to be wearing surgical masks. PPE supplies are sufficient as well as Covid testing supplies. LPA reviewed the Administrator Certificate (#6053006740 exp 7/25/2023) and Liability Insurance to be up to date. There were no deficiencies observed during today's inspection. Exit interview. Copy of report left at facility.