Pre-licensing visit·January 12, 2022

Licensing Program Analyst (LPA) Debbie Correia visited the facility to conduct a Pre-licensing inspection and a review of Component III. LPA Correia was met by Applicant Hideen Nucom, identified herself and was granted entry into the facility. Upon facility entry LPA Correia explained the purpose of the visit. During today's visit, LPA Correia, accompanied by Applicant Nucom, toured the facility and verified compliance with infection control practices. LPA and Applicant Nucom the reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; hand sanitizer/hand washing stations readily available; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of cleaning products and PPE. No deficiencies were cited during today’s visit. An exit interview was conducted with Applicant Nucom and a copy of this report, along with the Licensee Rights (LIC 9058 FAS 01/16) were provided to her via email. An electronic receipt of confirmation was requested to be sent by the Applicant upon receipt of the documents.