Routine inspection·May 19, 2021

Licensing Program Analyst (LPA) Cuadra conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and met with Administrator, Kelli Baumgartner. LPA conducted a Risk Assessment call with Administrator prior to the visit. There were 6 residents in care present at the facility. LPA arrived at the facility and had her temperature checked and logged into a sign-in sheet. LPA/Administrator conducted a tour through the facility and observed facility was a comfortable temperature and passageways were free from obstructions. Facility has a pool that is surrounded by a locked gate to ensure resident safety. Resident rooms were furnished per regulation. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Toxins were inspected and are stored in the locked laundry room. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire Extinguisher was found to be last charged on 05/2021 at the time of the visit. Smoke Detectors were found to be operational during the visit. Exit doors have auditory alert system that were functional at time of visit. Administrator Certificate for Administrator Kelli Baumgartner, 6008425740, expires on 9/6/21. Required postings were observed. Facility has submitted a mitigation program plan that has been approved on 1/20/2021. Posters have been placed at entrance, and facility entrance area has a designated area to screen visitors, thermometer and other items designated for visitors and staff before coming into work. Staff and residents are being monitored daily and results are documented in a binder for each month. Facility has PPE supplies stored in the storage/laundry room. Facility has a 30-day supply of medication for residents. Residents do not typically wear masks inside the facility but have them available. Facility has a designated outdoor visitation area. Facility has conducted staff training on infection control. Administrator will submit updates of the following documents by May 21, 2021: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500) Liability insurance and Emergency Disaster Plan (LIC610E). No deficiencies were cited during today's inspection.