Routine inspection·February 2, 2022

Licensing Program Analyst (LPA) Katrina Walters arrived unannounced to conduct a Required 1-Year Annual inspection and met with Administrator, Annalee Gomez and Licensee, Melissa Gomez. This facility submitted a mitigation plan, which was approved by community care licensing on 02/26/21. This inspection will focus on the infection control of this facility. When LPA arrived at the facility they were greeted by staff. At the entrance, there was a sign in sheet with a symptom check list, disposable mask and hand sanitizer. After visitors check in they are able to visit with residents in their bedroom or designated area . LPA toured the facility with staff and observed signs posted throughout the facility to promote droplet precautions. Signs were also posted in the bathrooms on the proper hand washing technique. Paper towels and antibacterial soap were also available in bathrooms used by residents and staff. All resident's room were furnished per regulation. Facility is able to isolate resident in an isolation room in the event of an outbreak. Isolation carts are stocked with PPE and placed outside of isolation room. Facility has a 30 day supply of Personal Protective Equipment and incontinence products. Facility is disinfected daily. Cleaning products were not accessible to residents in care. Facility has a 100% vaccination rate of staff and residents. Vaccination records are stored in appropriate folders. Residents do not typically wear a mask while in the facility, but they do wear masks when in the community. Per Administrator, all staff have received infection control training, but it has not yet been documented. LPA is requesting that all staff are re-trained on infection control, and facility staff document, the hours of training. Administrator to send proof of training to CCL attention LPA Katrina Walters by 2/16/22. No citations cited during todays visit.