Routine inspection·September 23, 2022

Licensing Program Analyst (LPA) Katrina Walters arrived unannounced to conduct a Required 1-Year Inspection and was greeted by staff. The Licensees, Imelda and Samuel Padama arrived later. LPA observed that SP's Administrator Certification was currently expired. Per SP they have submitted a request to have their Administrator Certificate updated, but have not yet received their updated certificate. LPA verified through the Administrator Certificate bureau that the certificate is pending. SP will post Administrator Certificate once received. The inspection is focused on the Infection Control procedures and practices of this facility. At primary entrance LPA observed a temperature logs and visitor sign-in sheet. Hand sanitizer was available for visitors. LPA conducted a walk through of the facility with staff and observed COVID postings throughout. Mitigation plan and Infection Control Plan was submitted and available for review. Hand sanitizer is kept throughout the facility. Per the Administrator staff are registered to have Personal Protective Equipment (PPE) /infection control training with local public health. Administrator maintains a binder with current COVID-19 protocols and contingency plans. LPA observed an inventory of PPE. Inventory of PPE is stored in garage and resident's bedrooms. LPA confirmed facility has at least a 30-day supply of PPE and incontinence products. High touch surface areas are disinfected daily. Due to current facility census, residents could isolate in their own bedrooms if they became ill. Facility was a comfortable temperature and exits were free from obstructions. The fire extinguisher was last inspected 03/15/2022. Auditory Alarms, Carbon Monoxide and Smoke detectors were tested and appeared to be in working order. Residents' emergency contact information has been updated and administrator confirmed staff are familiar with emergency procedures and protocols. All staff have conducted disaster drills and their annual disaster drills will be completed again in November. Sharps and toxins are secured and inaccessible to residents. Medications are centrally stored in a locked closer. All staff and residents are vaccinated and boosted. No deficiencies cited during today's visit.