Routine inspection·March 10, 2022

Unannounced annual visit made out to this facility on 03/10/2022 by Licensing Program Analyst (LPA) Charlie Yang and was met by the facility caregiver, Nicholas Duarte, who was requested by this LPA to go ahead and contact the facility designated Administrator to inform her that CCL was present at this time. The facility designated Administrator, Heather McClosky, arrived shortly thereafter to this facility. Brief interview conducted with the facility designated Administrator. This facility accepts and retains up to 8 residents at any given time, of which all (8) can be non ambulatory at any give time. Current census was 8 residents. Tour of this facility was conducted. Kitchen area was toured. Food storage units were reviewed for 2-day perishable and 7-day nonperishable food quantities. Additional food supplies were observed to be present in the front conference room. Freezer unit and additional nonperishable food quantities were present and observed at this time. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. A tour of the resident bedrooms was conducted. Bedroom furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. A tour of the resident restrooms was conducted. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 09/09/2021 by the local fire extinguisher company and in compliance at this time. Laundry area, located in exterior shed, was toured. Medication cart, located in the living area, was reviewed. It was observed to be locked and made inaccessible to the residents at this time. First aid kit was observed to be present and contained all of the required components at this time. Exterior grounds of this facility were toured. The facility perimeter fence, side gates, and exits were reviewed at this time. Linen closet was reviewed and observed to contain a sufficient supply of towels, sheets, and linens to be able to meet the needs of the residents at this time. The following forms and documents were requested to be updated and submitted into CCL: LIC 308 LIC 400 LIC 500 LIC 610 There were no deficiencies observed or cited during today's annual visit. Exit Interview