Routine inspection·January 18, 2023

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met Titus Popa, Administrator and Teodor Popa and Valerica Popa, caregivers. LPA explained purpose of inspection. LPA observed (4) residents in the common area and (2) residents in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (3). Currently, there is (1) resident 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 Administrator toured the interior and exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (2) resident bathrooms, kitchen, office and laundry/garage and staff area. 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. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps in the kitchen. LPA observed locked medications in a separate cabinet near the kitchen and locked toxins in the laundry room. LPA observed the inside temperature to be 76*F. LPA observed games/activities on site. The fire extinguisher was last serviced on 12/21/2022. All staff are cleared and associated to the facility. Discussed vaccination status of residents/staff and eligibility for boosters. Booster flyer was provided. LPA observed multiple Covid posters throughout as well as other required postings. LPA observed (2) unlocked gates from the inside back patio. There are no bodies of water or a pool. There is a walkway for residents and seating with a shade covering. LPA observed sufficient incontinent and PPE products on hand. Discussed PIN 22-28.1 issued 11/29/22 regarding visitation protocols. LPA observed RCFE Administrator certificate #6025324740- exp 3/7/23 .LPA obtained an updated copy of the LIC308 and current liability insurance and requested an updated copy of the LIC500 be provided by 1/28/23. There are no deficiencies issued during today's inspection. Exit interview. Copy of report provided.