Little Bird Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Victoria Bertozzi and Helena Rummonds arrived unannounced to conduct an Annual Required inspection and was greeted by staff. LPAs met with back up Administrator, Christopher Conradt and Administrator Katie Franco arrived at a later time. LPAs initiated a tour of the facility around 9:20am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 119 and 116 degrees F which are within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cabinets containing cleaning supplies were locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Emergency food and water supplies are stored in the garage along with Personal Protective Equipment. Fire extinguishers were last serviced June 2023. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational during inspection. Most recent fire/disaster drill was conducted 8/01/2023. Four staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates. Training records were reviewed. Administrative Certificate for Administrator, Katie Franco, 6017952740 is up to date and expires 1/28/2025. Medications and medication records were reviewed. Continued on LIC 809C Continued from LIC 809 Licensee/Administrator to submit updates of the following documents by 11/16/2023: LIC 500 Personnel Summary Copy of Liability Insurance LIC 610 Emergency Disaster Plan (If any changes) Infection Control Plan (If any changes) No deficiencies cited during this inspectionthe state’s words, verbatim · CDSS document, Oct 16, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and was welcome by staff Cecilia Pacheco who contacted assist. Administrator. Chris Conradt arrived during this visit and met with LPA. There are 6 residents with 3 under hospice at facility. Facility has activities planned for residents during the day. LPA arrived at the facility and had her temperature checked and logged. During facility tour on 8/15/2022 with licensee/administrator; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 06/2022 at the time of the visit. Sample test of Carbon monoxide detector was found to be operational during this visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Facility has no residents' with a special diet at this time. Toxins are stored in a locked laundry and garage area. Dangerous items were stored inaccessible to residents. There was a supply of cleaners, hygiene products and paper products available for clients. All resident’s bedrooms have lighting & appropriate furnishings. Disaster drills are being conducted with records for last fire drill on 8/1/2022. Continued LIC 809-C Infection Control: Facility has submitted a mitigation program plan that has been approved, and infection control plan has been submitted. Some posters have been placed at entrance and throughout of the facility. Facility has hand sanitizer available; visitors and staff before coming into work have temperature checked. Facility has PPE supply stored in garage area. There has been new staff hired and new resident’s admission since COVID. Residents’ medications are stored and locked in the kitchen cabinet. Facility has a 30-day supply of medication for clients. Residents are not wearing masks inside the facility, however; staff stated that they are able to wear masks when going on outings. All staff had masks on during this visit. Visitors are being allowed. Residents have also available virtual and telephone calls when contacting with family members and others. Staff stated that all required COVID training is on file in addition to N-95 fit testing for staff. There were no deficiencies cited at this time. Department is requesting facility to submit the following update documents by 8/22/2022: LIC 308 Designated LIC 610 Emergency Disaster Plan LIC 610E-S Supplemental Emergency Disaster Plan for RCFE LIC 9020 Register of Facility Client’s/Resident’s Copy of Certificate of Liability Insurance Copy of Administrator Certificatethe state’s words, verbatim · CDSS document, Aug 15, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and was welcome by assistant administrator Chris Conradt. Facility has 6 residents with 1 resident under hospice care. Facility has activities for residents such as singer outside, movie night, group working exercises, walks, and other activity plans for residents during the day. LPA arrived at the facility and had her temperature checked and logged into visitor’s binder. During facility tour on 8/25/2021 with staff Chris, facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 07/2021 at the time of the visit. Smoke Detectors & Carbon monoxide detector was found to be operational during the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked cabinet under the kitchen sink. Dangerous items were stored inaccessible to residents. There was a supply of cleaners, hygiene products and paper products available for clients. Residents' bedrooms have lighting & appropriate furnishings, and mattress pads are available for clients at the facility. Facility understands that hot water temperatures must measure degrees F within Title 22 acceptable regulations of 105 to 120 degrees F. Infection Control: Facility has submitted a mitigation program plan that has been approved. Posters have been placed at facility and entrance has small table with hand sanitizer and other items designated for visitors and staff before coming into work. Facility has PPE supply stored in outside garage. Facility has hired or admitted anyone new since COVID-19. Continue LIC 809-C Residents’ medications are stored and locked in the kitchen cabinet. Facility has a 30-day supply of medication for residents. Residents aren’t wearing masks inside the facility, however; licensee/admin stated that they are able to wear masks when going on outings. All staff had masks on during this visit. In addition, facility has a designated area for visitors which are being allowed for scheduled visits. Residents have also available Zoom and telephone calls when contacting with family members and others. Staff had all PPE training required on file and have obtained N-95 fit testing. LPAs advised facility to contact Local County Public Health and DSS/CCL Community Care Licensing immediately if symptoms or COVID-19 + in the facility. Disaster Drills have been conducted quarterly with the last one being conducted on 8/16/2021. There were no deficiencies cited at this time.the state’s words, verbatim · CDSS document, Aug 25, 2021

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.