Facility Evaluation Report

12/09/2021 Licensing Program Analyst (LPA) L. Holmes and Licensing Program Manager (LPM) Y. Flores-Larios conducted an unannounced annual inspection. At 10:30 AM upon arrival LPA and LPM met with Emily Rowley - Associate Executive Director (AED) and informed her of the purpose of the visit. Betty Dominici - Licensee and Andrew Dominici - Executive Director (ED), arrived about an hour later. Raj Ghandi, Chief Compliance Officer was also present throughout the visit.

Facility has a completed COVID-19 mitigation plan and submitted it to LPA for Community Care Licensing (CCL).

LPA and LPM inspected the facility inside and out with ED, Licensee and Chief Compliance Officer. LPA and LPM observed a screening station located near the front entrance with a visitor's log, hand sanitizer and thermometer. Routine symptom screening (+/-) temperature and symptom checks are done at entry for all staff and visitors by security. Residents are screened for COVID-19 symptoms, temperatures are checked daily and logged by staff. LPA and LPM observed COVID-19 signs posted in the facility and at the elevators. Trash bins were observed with touchless lids.

In the event of an outbreak, the 2nd and 3rd floor will be used for isolation with individual apartments, there is a staff break room and one dedicated entrance,

Medications are centrally stored in a locked medication room. Centrally stored PPEs were inspected and 3 isolation carts were observed. First aid kit inspected and observed complete with manual located in the medication room.

Exit interview conducted and a copy of this report provided.