Routine inspection·November 18, 2021

Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an annual required licensing inspection. This annual inspection was focused on infection control due to the COVID-19 pandemic. LPA was greeted at the front door by Caregiver, Katyln Cieslewicz and granted entry after identifying herself. LPA Hamilton explained the purpose of the visit. This facility serves six (6) elderly residents; age 60 and above; four (4) of whom may be non-ambulatory. During today's visit, LPA toured the facility and verified compliance with infection control practices. LPA and Caregiver, Cieslewicz reviewed the facility’s COVID-19 Mitigation Plan. LPA observed one central entry point; a sign-in policy enacted for all visitors, staff and residents; signs throughout the facility to promote hand hygiene, face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; and an adequate supply of PPE and disinfectants. Based on today's visit, no deficiencies were observed in the areas evaluated above. An exit interview was conducted with Caregiver, Cieslewicz and a copy of this report along with the Licensee/Appeal Rights (LIC 9058) was provided via email. An electronic receipt of confirmation was requested to be sent upon receipt of the documents.