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25 | Licensing Program Analyst (LPA) Katie Brown arrived at the facility unannounced to conduct the Annual Inspection - Infection Control. LPA met with and explained the purpose of the visit with Administrator/Facility Designee Alex Babakhani (AD).
LPA toured the facility inside and out. Upon entry, LPA observed visitor log/symptom screening and sanitizer. Covid-19 symptom and precautionary signs are posted at entry and throughout the facility. Furniture in common and dining areas are spaced to promote distancing. Facility has designated visitation areas available. LPA observed soap, paper towels and hand washing signs in bathrooms. LPA observed required food supply, paper products, 30 days of PPE and resident medications. Cleaning/disinfecting products and sharps/knives were locked. LPA reviewed resident emergency contact information. Fire extinguishers are dated 5/8/22. Fire and Carbon Monoxide alarms were observed in working order. Administrator Certification expiration: 5/17/2024
No deficiencies were cited during this inspection.
An exit interview was conducted. A copy of this report was left with AD whose signature confirms receipt of these documents.
LPA requested the following updated forms by 3/2/2023: Affidavit Regarding Client/Resident Cash Resources (LIC 400), Surety Bond (LIC 402 if applicable),Designation of Facility Responsibility (LIC 308), Affidavit Regarding Client/Resident Cash Resources (LIC 400), Surety Bond (LIC 402 if applicable), Personnel Report (LIC 500), Emergency Disaster Plan (610E), Client Roster (LIC 9020), Current Liability Coverage (documents reviewed during visit). |