Routine inspection·June 11, 2021

Licensing Program Analyst (LPA) K. Hiratsuka, arrived at the facility unannounced on 06/11/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Facility Representatives Melissa Johnson and explained the purpose of the visit. Prior to initiating the annual inspection visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Facility Representative and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by Melissa Johnson.. LPA is doing this visit at the same time as New Vision Services Senior Care 3 #455002745, because they share a backyard. This facility has a fire clearance for all non-ambulatory residents. The main entrance opens to a small foyer. To the right of the main entrance is a hallway that leads to five private residents and two full common bathrooms. Two of the bedrooms have exits to the outside. Across the main entrance leads to the main sitting area, kitchen, and dining area. To the left of the kitchen and dining area is another sitting area separated by a half wall. There is a door leading to the garage and a sixth private room that has an exit to the outside. The backyard was inspected. This facility has a covered back patio. The backyard shares space with two other facilities licensed by the same licensee. They are NEW VISION SERVICES SENIOR CARE 3 # 455002745; and NEW VISION SERVICES SENIOR CARE 1 # 455002748. There are two locked sheds in the shared backyards. Several topics were discussed as well as infection control. The following needs to be updated and submitted to CCLD by the end of June 2021: LIC 500 facility personnel or staff schedule LIC 308 designation of administrative responsibility. letter stating who the current administrator is. No deficiencies cited.