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

Infection Control:

• COVID-19 visitor screening is no longer in place. Infection control practices and Personal Protective Equipment (PPEs) were observed. Each client room is designated as a COVID-19 isolation room if needed. An Infection Control Plan and COVID-19 Mitigation Plan have been submitted to CCL.

• Plan of Operation is in place. The Infection Control Plan has been added to the Plan.
• A fire clearance for 6 non-ambulatory residents age 60 and above, who are legally blind is in place.
• Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place.
• Surety Bond is current. The facility handles resident monies. Ledgers and monies are kept at corporate office.

• The facility is a single story home located in a residential neighborhood that is licensed for 6 non-ambulatory clients. The facility serves legally blind clients. It consists of 4 client bedrooms, living room, dining room, family room, kitchen, laundry area, 3 bathrooms, backyard patio area, and detached garage.
• The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Cleaning supplies and toxic substances are inaccessible to residents.
• The facility has fully charged fire extinguishers and a sprinkler system. Smoke and carbon monoxide detectors were tested and are operational.
• Water temperature readings measured within the required 105 - 120 degrees Fahrenheit.

• Sufficient staff members provide care and supervision to the clients.

• Administrator certificate expires 10/1/2024.
• Staff have criminal background clearance and training.
• Five (5) staff files were reviewed and contained proof of staff training, health clearance, 1st Aid/CPR/CPI training was observed.

• A total of four (4) resident files were reviewed. They contained admission agreements, Physician's Reports, Appraisasl, IPP/Behavior Reports, TB clearance, Functional Capability Assessment, Physician's Orders, medical consent, and medication records.
• RCFE complaint poster and Personal rights were observed posted.

• Sufficient space to accommodate both indoor and outdoor activities was observed.
• An activity calendar is posted.
• The facility does not have an active Resident Council.

• Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies.
• Physician orders for modified diets are on file.
• Sanitation practices and kitchen cleanliness was observed.

• Four (4) centrally stored resident medications were reviewed containing 30-day supply of medications.
• Medical and dental transportation is provided by facility staff.

• Emergency and Disaster Plan LIC 610E is in place. There is no evacuation chair at each stairway. Citation was issued.
• The last quarterly emergency drill was conducted on 5/3/2023.
• Records of resident Appraisal and Needs services plans are part of Emergency training.

• No residents receive home health or hospice care.
• No postural support physician orders are on file.
• No half and full bed rails for mobility assistance were observed in resident rooms.
• Individual Service Plans and Appraisals are on file.
• No residents have prohibited health conditions.