Routine inspection·March 23, 2023

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct an Annual Required 1 Year inspection and met with Administrator, Suzette Tawzar. Upon arrival, LPA observed that staff continue to wear masks per current guidance. LPA initiated a tour of the facility and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Residents rooms were furnished per regulation. Water temperature in bathrooms measured at 112 and 117 degrees F which is within the required allowed regulation range of 105 to 120 degrees F. Extra hygiene products and linens were available. Cabinet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Fire extinguisher were last inspected March 3, 2023. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational. Exit doors have an auditory alarms to alert staff, if a door is opened. Three staff files and 3 resident files were reviewed. Staff have required First Aid and CPR certificates but lack the required Health screenings and required staff training. Administrator Certificate for, Suzette Tawzer expires 12/27/2023. Continued on LIC809C Continued from LIC809 One of six residents did not have a fully signed pre-appraisal on file or completed/signed Admission Agreement. Per conversation with Administrator, resident, R1s POA was returning to the facility to complete. LPA discussed with Administrator, that the left side yard gate is not opening properly and getting stuck, gate is also not self closing and latching as required and needs to be repaired and corrected. In addition LPA went over several areas (8) the backyard wooded deck that are loose, broken and not firm and will be required to be correct or replace. Administrator and LPA discussed their Emergency Disaster Plan and Infection Control Plan. Licensee/Administrator to submit updates of the following documents by 4/21/2023: LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (If changes) LIC9020 Register of Residents LIC308 Designation of Responsibility Infection Control Plan (If changes) Liability Insurance Copy of current Lease Agreement current facility sketch LPA was unable to review medication and 3 additional resident files and will return at a later date to complete annual inspection. No deficiencies cited at this time, LPA will return and issue citations warranted.