Routine inspection·December 6, 2022

On December 6, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. Upon arrival, LPA observed the COVID-19 signage posted at the front entrance. LPA met with Administrator Jenilee Patalot and Licensee, Rufina Caingcoy and explained the purpose of the visit. LPA observed a copy of residents, visitors, and staff screening log documentation. LPA toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story home with 5 resident rooms, 1 staff room, 2 full bathrooms and an office/storage room. LPA toured the facility with the administrator and observed living room and dining room to be clean and free from any tripping hazards. A comfortable temperature of 78 degrees F is maintained and lighting is sufficient for comfort. During the visit, LPA observed two residents having lunch together and maintaining social distancing. LPA toured the resident rooms and observed all 5 resident rooms to be private rooms. LPA observed 2 full bathrooms to be equipped with liquid soap, paper towels, and non-skid mats. LPA advised administrator to ensure that trash cans have a fitted lid and to put up hand-washing signs. Bathrooms were odor-free and in good repair. LPA observed extra linen present. First aid kit was observed to be completed. LPA observed Room 3 (as indicated on the facility floor plan) to have a working door alarm. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable. Sharps, chemicals, and medications were observed to be locked and inaccessible to residents. LPA toured the garage and observed the extra food supply and supplies closet. In addition, LPA observed a washer and dryer outside to be in good working condition. 30-day PPE supply was present. LPA observed the office/storage room located right next to the garage to have personal belongings. Infection control practices are observed: entry procedures, daily monitoring log for staff, residents and visitors, 30-day PPE supply, face coverings for staff, containment strategies, staff training and policies, COVID-19 signage posted throughout the facility. CONT. to 809C LPA requests the following forms to be submitted to CCL by 12/13/22: -LIC308 Designation of Administrator Responsibility -LIC500 Personnel Report -LIC610E Emergency Disaster Plan -Administrator Certificate No citations will be issued during this visit. Report is reviewed with Administrator and a copy is provided.