The facility was last inspected on 04/24/2019 for an annual inspection. It is a two story building with 5 bedrooms, 2 bathrooms, kitchen, nook, living room, recreation room, dining room, storage closets, garage, front yard, and back yard. The fifth bedroom is upstairs and is not included on the facility sketch. The facility has an approved fire clearance for 6 ambulatory clients.

Screening: LPA was not screened for symptoms of infectious disease upon entry. LPA advised staff to screen all visitors upon entry and record symptoms, temperature, and contact tracing information in a visitor log. Staff was wearing a surgical mask.

Bedrooms: The facility has 5 bedrooms in total. The bedroom on the second floor is a staff bedroom. It had stairs with a chair lift leading to the room. The bedroom on the northeast corner of the facility is designated as a staff office. Both rooms were locked. All other bedrooms are shared bedrooms. Bedroom #1 was nearest to the kitchen and was unoccupied. Bedroom #2 on the northwest corner was occupied by one client. Bedroom #3 was by the water heater. All bedrooms contained a chair, nightstand, dresser or storage, lamp, and beds with adequate bedding. All beds were at least 6 feet apart to accommodate social distancing. All furniture was clean and in good repair.

Bathrooms: LPA inspected the bathroom designated for clients. It contained a wind hand dryer. A trash can with a tight fitting lid was outside of the bathroom. Staff provide paper towels upon request. Staff reported that clients use their individual soap. LPA advised to put paper towels, the trash can, and a handwashing instruction sign in the bathroom. At 2:17 p.m. LPA measured the water temperature to be 109.2 degrees Fahrenheit. The bathroom designated for staff contained liquid soap, paper towels, and a trash can.

Nook: LPA observed 1 table and 6 chairs. Postings on a bulletin board included the facility license, administrator certificate, personal rights, confidential complaint information, house rules, emergency disaster plan, and a weekly menu.

Common areas: Walls, floors, ceilings, blinds, and window screens were all in good condition. LPA observed a surveillance camera in the recreation room. A client was sitting on the couch and watching television. LPA also saw a house telephone and board games available. The facility uses hand written signs promoting physical distancing and handwashing. At approximately 2:05 p.m. the room temperature was measured at 79 degrees Fahrenheit. The facility has a light in the hallway with motion sensors. LPA observed two storage closets with linens and bedsheets. Staff informed LPA that a cleaning crew comes twice each month when clients are not at the facility.

Outdoor area: LPA observed a floodlight and a covered patio area. All furniture was in good condition. The back yard was maintained. Staff reported gardeners came earlier in the day.

Garage: The garage was locked. Access is maintained by remote control. LPA observed 3 freezers and 1 refrigerator in the garage. They contained adequate supplies of perishable and non-perishable food. LPA also observed more non-perishable food stored on shelves. In cabinets, LPA observed toxins, paint, paper supplies, and cleaning solutions. They were stored separate from food.

Safety: Emergency exit paths were clear and free from hazards. The exit gate to the front yard was unlocked. Exit doors in the kitchen and at the front were locked from the outside but unlocked from the inside. At 1:55 p.m. the smoke detector in Bedroom #3 was tested to be functional. At 2:03 p.m. carbon monoxide detector in the hallway was tested to be operational. At 2:15 p.m. LPA observed a fire extinguisher hung in the kitchen. It was fully charged and last inspected on 01/04/2022.

During today's visit, the facility is in compliance with Title 22 regulations. No citations issued.

Exit interview conducted. Copy of report and technical assistance issued.