The LPA and staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

KITCHEN: The LPA began the inspection in the Kitchen/food service area at approximately 10:20 a.m. Knives and cleaning supplies are locked and stored inaccessible. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food all food was observed to be of good quality.

GARAGE: The garage is attached to the home. Access to the garage is through the kitchen. There is a laundry area located in the garage where the washer and dryer are held, laundry supplies and cleaning supplies are kept locked. There is a pantry with additional non-perishable food items and a refrigerator freezer with additional perishable food items all food was observed be of good quality. There is a sufficient supply of emergency food and water kept in the garage.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 75 degrees. The smoke detector(s) and carbon monoxide detector(s) were tested at 11:05 a.m. and operational at the time of the visit. The two (2) fire extinguishers were fully charged and were last serviced March 21, 2023. The LPA observed the required postings throughout the common spaces.

**Continued on LIC 809-C**

BATHROOMS: The five (5) resident bathrooms and one (1) visitor/staff bathroom were clean, sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature in bathrooms measured between 112.4-114.4 degrees Fahrenheit.

OUTDOOR AREA: The backyard has an outdoor area equipped with furniture and shade for client use. There is a side gate for emergency exit and is single latched. No bodies of water noted.

RECORDS: Personnel records review began at 11:15 a.m., records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order.

Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order.

MEDICATIONS: Medications review began at 12:20 p.m.; medications are centrally stored and locked in a closet in the kitchen to the right of refrigerator. Medications are labeled and checked for expiration dates, prescription numbers and date filled. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review.

INFECTION CONTROL: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. The facility has an adequate supply of Personal Protection 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 a single isolation room if the facility has a confirmed case of COVID-19.

The LPA obtained the following documents: