Routine inspection·November 4, 2022

Licensing Program Analyst (LPA) Canela arrived unannounced, to conduct an Annual Required 1 YR inspection and was greeted by care staff, Administrator, Marivie Fabie arrived a few minutes later. The inspection is focused on the Infection Control procedures and practices of this facility Upon arrival, LPA observed that facility has Covid posters on the front door. LPA discussed visitation procedures with administrator, documenting & screening questions. Once inside the facility, LPA observed that facility has a sign-in for visitors, screening area with PPE . LPA observed that staff were wearing masks during today's visit. LPA conducted a walk-through of the facility and observed Covid-19 posters that included hand washing signs in restrooms, but no paper towels. Facility was a comfortable temperature. Residents are encouraged to wear masks when in the community. Commonly touched surfaces are disinfected throughout the day. All residents have their own private room and may be isolated if the need arises. Facility staff have been trained on PPE Facility has submitted their Covid-19 Mitigation Plan and it was approved on 8/20/2021. Facility has more than a 30 day supply of Personal Protective Equipment (PPE) including but not limited to masks, face shields, gowns and hand sanitizer. PPE is in a location that is stored and accessible to staff. Facility maintains a 30 day supply of medication. LPA consulted regarding the backyard deck wood rails that need to be secured, firm and in good condition. LPA went over resident R1 who has a small sofa in her room instead of a regular bed. LPA and Administrator discussed requirements and doctors note required for review of R1s room and paperwork needed to review for request of approval. Continue report See LIC809-C LPA requested the following updated records to be submitted to Community Care Licensing by 11/22/2022 · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources · LIC 402 Surety Bond, if applicable · LIC 610D Emergency Disaster Plan · LIC 9020 Register of Facility Residents · Copy of current, updated facility Sketch · Copy of Liability insurance · Copy Administrator Certificate · Copy of Admission Agreement Exit interview conducted with Marivie Fabie, Licensee/Administrator. No deficiencies cited during this inspection