Routine inspection·June 29, 2021

Licensing Program Analysts (LPA), Farhaan Sarangi and Erik Gonzalez Campos arrived unannounced to conduct a Required 1 year inspection at approximately 10:00 AM, and met with administrator Josephine Sana. The inspection is focused on the Infection Control procedures and practices of this facility. Upon entry LPAs were greeted by staff and and asked to sign in after COVID symptom screening. At primary entrance LPAs observed temperature logs and visitor sign-in sheet. LPAs conducted walk through of the facility with S1. Administrator arrived later. LPAs observed COVID postings throughout. Mitigation plan has been submitted and approved by Community Care Licensing (CCL). Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer is kept throughout the facility. Staff have completed Personal Protective Equipment (PPE) and infection control training through the Department of Public Health. Staff have not been N95 fit tested. High touch surface areas are disinfected daily. Due to current facility census, residents could isolate in their own rooms if they became ill. LPAs confirmed administrator has necessary PPE equipment and supplies to support a resident in isolation. Residents' emergency contact information has been updated and administrator confirmed staff are familiar with 911 procedures and protocols. Toxins are secured and inaccessible in locked garage cabinet. A 30 day supply of medications are stored in a locked cabinet inside administrator's office making them inaccessible to residents. The facility has a sufficient supply of Personal Protective Equipment (PPE) and hygiene supplies. LPAs were shown binder where documentation of fire drills and smoke detector tests are kept, documentation was current. Facility is conducting COVID-19 surveillance testing per CCL guidelines. Continued on LIC 809C Facility is allowing residents to have meals in the dining room and furniture is set up for social distancing. Common areas are also set up for social distancing. Upon examination of facility roster it was found one staff S2 was not associated. LPAs advised administrator to have S2 associated. LPAs observed backyard fence under remodel and requested notification through email to CCL. LPAs requested the following documents: LIC 309 LIC 400 LIC 500 LIC 402 Administrator Certificate Administrator and LPAs discussed their Emergency Disaster Plan and confirmed it is current. LPAs unable to print, will email report and supporting documentation to administrator No deficiencies cited during this inspection