Routine inspection·November 28, 2022

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Helen Ibrahim . Upon arrival, HM took LPA body temperature, asked the infection control questionnaires, and checked LPA in the visitor log book. LPA toured the facility inside out with HM. COVID posters were observed at main entrance and the facility. Screening station with masks, hand sanitizer, thermometer and visitor log book was observed at the main entrance. Living room, kitchen, dinning room and 4 restrooms were inspected. Not all trash cans were observed with covers. ADM stated the facility will chang all the trash cans with covers. Paper towels were observed with holders.6 resident bedrooms, and laundry room were inspected. One staff live-in room was observed in facility. Cloth towels were observed in kitchen. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. PPE supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 74 degree F, and hot water temperature was at 107 degree F in facility. 3 Staff and 5 residents were observed in facility Fire extinguisher was serviced on 3/15/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. ADM stated all the residents and staff are fully vaccinated and done with booster. ADM stated the facility already submitted Infection Control Plan to CCL office. No citation were noted today. Exit interview was conducted with ADM. A copy of this report was provided to HM..