Facility Evaluation Report

Licensing Program Analyst (LPA) Bruce Jacobs arrived at the care home to conduct an unannounced Annual Inspection. Facility Administrator Victoria Kachan was informed of the purpose of the visit and was able to assist with the completion of the inspection focusing on the facility's mitigation plan and infection control procedures. The facility has submitted a written mitigation plan (LIC 808) and LPA reviewed and discussed the plan and current Licensing guidance.. Administrator's Certification for Victoria Kachan is 6048846740 expires 8/5/22.

LPA toured the facility and reviewed the Mitigation Plan as well as discussing COVID Training Procedures during the Inspection. Smoke alarms and smoke detectors are hard wired to the facility, were tested are operational. Fire extinguishers were serviced in April 2021 and are in compliance. Facility has carbon monoxide detectors that are operational. Medication were locked and facility was determined to have an adequate food supply. Facility's PPE supplies were observed and determined to be adequate for a 30 supply.

The interior and outdoor area of the home was inspected including bedrooms, kitchen, bathrooms, and common areas for this home. There are five clients in the home and 5 client bedrooms, There are two client bathrooms that were viewed and are in compliance with grab bars and non-skid mats. One resident is on hospice and several with dementia.