Routine inspection·July 23, 2021

Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced 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 Gloria Llanos and granted entry after identifying herself. LPA discussed the purpose of the visit with Licensee, Monica Allan. This facility serves six (6) residents, age 60 and above. All of whom may be non-ambulatory, and one (1) of whom may be bedridden in bedrooms #2 and #5 only. Hospice waiver approved for two (2). During today's visit, LPA toured the facility, and verified compliance with infection control practices. LPA and Licensee Allan reviewed the facility’s COVID-19 Mitigation Plan. LPA observed one central entry point; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of disinfectants. LPA discussed the Provider Information Notice (PIN) regarding updated guidance on visitation. Based on today's visit, no deficiencies were observed in the areas evaluated above. An exit interview was conducted with Licensee Allan 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 by the Licensee upon receipt of the documents.