Routine inspection·July 19, 2021

Community Care Licensing (CCL) staff Mariya Melnichuk and Licensing Program Analyst (LPA) Wolter arrived at the facility unannounced on 07/19/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPA met with administrator, Oksana Doldier and explained the purpose of the visit. Prior to initiating the annual inspection, CCL staff and LPA completed required COVID-19 testing protocols, and self-screened for symptoms of COVID-19. CCL staff and LPA wore the following Personal Protective Equipment (PPE) during today's visit: surgical masks. Administrator took CCL staff and LPA's temperature upon arrival. CCL staff, LPA and administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, brief inspection of five (5) resident bedrooms, bathroom, garage, backyard, and additional building. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and administrator completed the infection control domain together 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. Administrator to send in updated copy of LIC 308 - Designation of Facility Responsibility, LIC 500 - Personnel Report, LIC 999 - Facility Sketch and current copy of Liability Insurance to update facility file to Community Care Licensing by 07/26/2021.