Routine inspection·June 9, 2022

On June 9, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. Upon arrival LPA observed the COVID signage postage on the front door. LPA met with Licensee, Ajenshi Govind and Administrator, Godfred Gardue joined shortly thereafter. LPA explained the purpose of the visit. LPA was screened at entry point and Licensee was able to provide LPA with screening log documentation for visitors. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story facility with 4 bedrooms; 3 private resident bedrooms, 1 office room and 2 full bathrooms. 1 out of the 3 resident rooms are vacant at this time. Infection control practices are present: entry procedures, face coverings, daily monitoring for residents and staff, COVID-19 signage posted throughout the facility, and 30-day PPE supply. Both bathrooms are equipped with liquid soap, paper towels and trash cans are covered with lids. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable present. Medications, toxins and sharps are stored appropriately and inaccessible to residents, and a comfortable temperature is maintained, lighting is sufficient for comfort. First aid kit was observed to be completed. Extra linen was observed to be present. LPA requested for the following to be submitted to CCLD by 6/16/2022 LIC309 Administrative Organization LIC308 Designation of Administrative Responsibility LIC500 Personnel Report LIC400 Resident Cash Resources LIC402 Surety Bond Administrator Certificate LIC610D Emergency Disaster Plan Report is reviewed with Licensee and Administrator and a copy is provided.