Routine inspection·November 29, 2022

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Tetyana Hankevych, Co-Administrator/caregiver and explained purpose of inspection. LPA also met with Adina Sbingu, assistant staff person. LPA observed (2) residents in the common area and (3) residents in their rooms at the start of the inspection. LPA was advised that (1) resident is currently in the hospital. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (2). Currently, there are (0) residents on hospice. Prior to initiating today's inspection, LPA completed required COVID-19 Department protocols, wore a surgical mask and was screened per Covid-19 precautionary measures upon entering the facility. LPA and the Co-Administrators toured the interior of the facility including the common areas, (4) resident bedrooms with private bathrooms, (1) shared bedroom with bathroom in hallway, kitchen, staff room and laundry area. The upstairs area is used by staff only. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters posted. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and daily medications in the kitchen. LPA observed locked toxins in the laundry room and locked medications in a closet. LPA observed the inside temperature to be 72*F. Fire extinguisher was last serviced 6/30/22. Discussed vaccination status of residents/staff, eligibility for boosters, and booster flyer provided. LPA observed multiple Covid posters throughout as well as other required postings. LPA observed (1) unlocked gate from the inside back patio. LPA observed the front and back concrete areas being power washed during the inspection. There are no bodies of water or a pool. LPA observed sufficient incontinent products and PPE products on hand. Discussed PIN 22-28.1 issued 11/29/22 regarding visitation protocols. LPA was advised that Tetyana Hankevych will be the official Administrator on/around 1/1/23. Additional paperwork to be submitted to CCLD for the change. LPA obtained an updated copy of LIC500, LIC308 copy of the current liability insurance. There are no deficiencies issued during today's inspection. Exit interview. Copy of report provided.