Routine inspection·June 28, 2021

Licensing Program Analyst (LPA) Konnor Leitzell arrived at the facility unannounced on 06/28/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPA met with Emilia Petcu (Designated Administrator/Caregiver) 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; 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 Masks. Additionally, LPA was screened by Emilia and responses were documented in the visitor screening log. LPA and Emilia toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, dining room, five (5) of five (5) resident bedrooms, two (2) resident (2) bathrooms, one (1) of one (1) staff bathroom, staff room, kitchen, storage, garage and backyard. LPA conducted interviews with three (3) of six (6) residents in care. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and admin 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.