Routine inspection·July 21, 2022

On 7/21/2022 Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required annual. LPA met with Caregiver, Mark Rodil, who contacted Licensee, Aida Broines, who informed LPA that she cannot make it and Caregiver can act in her behalf. LPA explained purpose of inspection to Caregiver. LPA observed Caregiver to not have a mask on when LPA entered the facility. LPA informed Caregiver the COVID mask requirement and asked Caregiver to put on a surgical mask. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and confirmed the facility does not currently have any positive Covid-19 diagnoses. Additionally, LPA were 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. Facility currently has (6) residents. LPA observed (3) residents to be eating in the dining area, (1) resident to be watching television in the common area, (1) resident in the backyard, and (1) resident to be sleeping in his room. LPA and Caregiver toured the interior of the facility, including (2) shared resident room, (1) private resident room, bathrooms, kitchen, laundry room, staff office and common areas. LPA observed it to be clean and in good repair. LPA observed various Covid posters throughout the facility. In the areas toured no immediate health, safety, or personal rights violations were observed. Inside temperature was observed to be 73*F. LPA observed paper towels, soap, sanitizer and Covid posters and a trash can with lid in the bathrooms. LPA observed ample PPE supply. Sharps, Toxins and medications were secured. LPA observed current Administrator certificates posted. LPA advised Caregiver the CCLD "If You See Something" poster should be reprinted to a bigger size. LPA observed the fire extinguisher to be last serviced on April 10, 2020. LPA requested a current copy of liability insurance and proof of an up to date fire extinguisher by Friday 7/22/2022. As a result of this visit, see attached deficiencies . Exit interview conducted and copy of report and appeal rights provide d.