Facility Evaluation Report

At approximately 9:40AM, Licensing Program Analyst (LPA) Carol Fowler arrived unannounced to conduct a Required 1 Year annual inspection and met with Staff Member, Elizabeth Bryant, LVN. Facility has an approved fire clearance for five (5) bedridden residents for a total capacity of five (5) residents.

LPA conducted a tour of the facility and observed the following: the facility was clean and at a comfortable temperature with all exits free from obstruction. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. There is a sufficient supply of hygiene products, paper products, and linens available for resident use. Medication was centrally stored and secure.

LPA reviewed 3 of 5 resident records which were all complete. LPA also reviewed 4 staff files which were found to be organized with proper documentation.

Administrator's Certificate (6054192735) was current with an expiration date of 01/10/2025.

LPA discussed facility's emergency and evacuation plan. The facility's last fire and evacuation drill was conducted 01/01/2024. Facility's fire extinguishers were last inspected 12/14/2023. Smoke detectors and carbon monoxide detectors were tested and operational. The amount of fresh and non-perishable foods are within regulation. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit.