The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs.

Infection Control:

· Infection control practices and Personal Protective Equipment (PPEs) were observed. Infection Control Plan will be submitted to LPA within seven (7) days.

· The facility is a single-story home located in a residential neighborhood. It is licensed for a capacity of six (6) residents, all of which may be non-ambulatory, four (4) may be receiving hospice. It has four (4) resident bedrooms, a dining room, a living room, a kitchen which contains the washer and dryer machines for the facility, two (2) residents bathrooms of which Restroom #1 had a hot water temperature reading at 109.7 Degrees F and Restroom #2 had a hot water temperature reading of 107.2 Degrees F, a backyard patio which contained a shaded area for residents, and also a detached garage that functions as the facility’s storage and holds additional food and incontinence supplies. Cleaning supplies and chemicals are kept locked in the kitchen of the facility.

· Physician orders were reviewed for four (4) resident files.

· Medications were also reviewed for four (4) residents.

Resident Records/Incident Reports:

· Four (4) resident files were reviewed containing admission agreements, Physician's Report, medical/functional assessments, Needs and Services Plans, TB clearance, Appraisal/Needs and Services Plan, personal rights, medical consent, and medication records were reviewed.

· The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary.