Routine inspection·November 22, 2022

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Our Lady of Peace Home Care for the purpose of conducting a Required 1 year inspection. LPA was greeted at the door by Administrator, Romeo Cabe, and was granted access into the facility. LPA toured the building and grounds with the Administrator and observed the facility to be clean and a comfortable temperature of 73 degrees F. LPA observed at least a minimum of a 2 day supply of perishable and 7 day supply of non-perishable food necessary for 6 residents in care. Food was found to be stored in a safe manner. Water temperature measured at 110 degrees F in both residents bathrooms, which is within regulation between 105 and 120 degrees F in faucets used by residents. There was an ample supply of linens, cleaners, hygiene products and paper products available for residents. Toxins were inspected and are located in a locked cabinet under the kitchen sink and in a cabinet in the laundry room. All resident's bathrooms contained necessary grab bars and non-slip floors/mats. Medication is centrally stored in a locked closet in the resident hallway. All bedrooms are equipped with lighting and proper bedding which was clean and in good repair. Fire extinguishers were last inspected August 2022. Smoke detectors located throughout the facility were tested and operational during the inspection. Carbon monoxide detector was observed in the dinning area and in working order. Exit doors have auditory alert system that was functional at time of inspection. LPA observed an installed fire pull system with wired auditory and visual alarms throughout the facility. Last emergency drill was conducted on October 2022. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms or COVID-19 + in the facility. Facility has PPE supply stored in the bedroom walk-in closet. Facility is N95 Fit tested in September 2022. (Report continued on LIC 809C) ` LPA requested the following documents to be sent: LIC 500- Personnel Report LIC 308- Designation of Responsibility LIC 309- Administrative Organization LIC 400- Affidavit regarding Client Cash Resources Updated facility sketch Updated Emergency Disaster Plan (LIC 610D) Surety Bond Most up-to-date Liability insurance Control of Property Register of residents No deficiencies were observed or cited during today's Required 1 year inspection. Exit interview was conducted and a copy of this report was emailed to the facility Administrator due to printer issues.