Routine inspection·October 13, 2022

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 10/13/2022 at 10:03am. LPA met with facility Administrator Biao Zhang. LPA toured the facility, including living room, kitchen, family room, garage, office, 4 bedrooms, 2 bathrooms, back patio, backyard, and storage sheds. All staff members observed to be wearing masks. Admin confirmed that all staff and residents have been vaccinated. All emergency exits noted to be clear of obstruction. Bathrooms observed to have paper towels, and liquid soap, but no hand washing signs. Fire extinguisher observed to be inspected on December 2021. Smoke/carbon monoxide detectors tested and observed to be operational. Facility observed to have designated entry point. Staff took LPA's temperature, but did not screen for symptoms. Facility sign in sheet noted to not have tracking log for symptom screening. Facility does not have 30-days supply of N95s and gowns. Water temperature observed to be 105.0 *F. Facility temperature observed to be 71*F. During inspection of facility bathroom, LPA observed Lysol on bathroom counter top. Admin placed Lysol bottle under the bathroom sink, where other cleaning supplies were observed. Bathroom is accessible and utilized by residents with dementia at the facility. Admin stated that the cleaning supplies belonged to an independent resident that liked to keep his bathroom clean. LPA further observed detergent and laundry pods accessible to residents in the facility garage which is unlocked. Admin placed laundry supplies in a locked cabinet with other laundry supplies. Deficiency cited, advisory notes issued. This report was reviewed with Administrator Biao Zhang and a copy of the signed report was provided.