Routine inspection·February 18, 2023

At 11:30am on 02/18/2023, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to conduct the annual, infection control inspection. LPA met with Administrator Thelma Tablaba announced who he was and the reason for the visit. LPA reviewed facilities staff clearance roster with Administrator and found that care giver Lydia (S1) was not associated to the facility. Administrator was able to show LPA documentation of S1 being cleared and having a SID number. LPA advised Administrator it have S1 associated to this facility through the Guardian system before the end of the day 02/18/2023. Administrator and LPA conducted a cursory tour of the facility, LPA noted that the facility has one double occupancy resident room and three single occupancy resident rooms. LPA noted that the facility has two living room, kitchen and dining area for residents. LPA noted that the water temperature in within regulation parameters of 105*'120*(f). LPA noted that fire detectors were located through out the facility and the carbon monoxide detector was located in the hallway. LPA note that the facility had a self screening station outside next to the front door and a second screening station on the inside right next to the front door. LPA noted that the facility had at least two days of perishable and at least seven days of non-perishable foods on hand at the facility. LPA noted that the facility has 30 days supply of PPE on hand. LPA noted that bathroom are stocked with liquid soap and paper towels. LPA noted that no violations, technical, or citations were issued as a result of the cursory walk through tour of the facility. Licensee arrived at facility at approximately 12;30PM. Administrator, Licensee Linda Ave and LPA conducted the infection control portion of the annual inspection. A techenial assistance was issued for staff not wearing masks. No other violations, technical, or citations were issued during the infection control module of the annual inspection. Administrator, Licensee Linda Ave and LPA discussed Provider Information Notice (PIN)23-02-ASC and the new best practice guidelines pertaining to infection control, and COVID-19. LPA noted that a single technical advisory was issued on this annual, infection control inspection. LPA noted that no other violation, technical or citation was issued at this time for the annual, infection control inspection. Exit interview, report signed and report provided.