Routine inspection·June 29, 2022

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 8:58 AM. This annual had a specific emphasis on infection control practices and procedures. The LPA met with Facility Designee Flordeliza (Baby) Hipolito and discussed the reason for the visit. Entrance interview conducted. The LPA, along with Facility Designee, toured the physical plant areas inside and outside at 9:05AM to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS: Due to COVID positive residents isolating inside the facility, the LPA observed the resident bedrooms from the common hallways only. Resident bedrooms appeared to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 20 (twenty) total bedrooms; 4 (four) are private resident rooms and 16 (sixteen) are shared resident rooms. RESTROOMS: Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. LPA observed sufficient amounts of soap and paper products in each restroom, as well as hand washing posters. Water temperature was tested in a sampling of resident restrooms, which was measured at 109 degrees Fahrenheit and 110.5 degrees Fahrenheit, within the required range. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common hallway. Fire extinguishes were observed to be fully charged and serviced on 08/24/2021. The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. Report Continued on LIC 809-C KITCHEN : Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. INFECTION CONTROL: During today’s visit, the LPA spoke with the Facility Designee regarding the facility’s infection control practices at 09:25AM. Prior to entry, the facility has a central entry point for symptom screening. The facility is allowing visitors, in accordance with PINs and Public Health guidance. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate isolation rooms if there is a confirmed case of COVID-19. The facility is currently and has previously managed COVID-19 active cases and the facility complied with all requirements set forth by the local health department and licensing. Staff are up to date regarding guidelines pertaining to visitation and vaccine requirements. The community's policies and procedures pertaining to infection control were adequate. No citations were issued during today’s visit. Exit interview conducted. A copy of the report was provided via email.