Facility Evaluation Report

On April 8, 2026, Licensing Program Analyst (LPA) Kayla Adkison and Licensing Program Manager (LPM) arrived at the facility unannounced to conduct a Required Annual Inspection. LPA met with Administrative Assistant (AA) Lillyana Vaughn, and explained the purpose of the visit. LPA spoke with Administrator Grace Hawkins via telephone and confirmed AA would proceed with completing the inspection

During the inspection, there were 26 residents and 5 (five) staff providing direct care. LPA observed residents having lunch, watching television, listening to musical performer, and participating in a physical activity with the Activities Coordinator.

LPA, LPM and AA toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to: common areas, five (5) resident bedrooms and bathrooms, courtyard, kitchen, and storage areas. LPA observed two common bathrooms in need of cleaning. LPA observed the alarm for one exterior door to be turned off or inoperable. LPA noted in two (2) bedrooms, resident's beds were placed in a position where residents were unable to reach their emergency pull cords in the event the cord was dropped or not placed directly nest to the resident. LPA observed one exterior exit door to be blocked by the presence of a hoyer lift and resident wheelchair.

LPA observed each bedroom to have the required furnishings and working lights. LPA observed the facility to be at a comfortable temperature. LPA observed a calendar of activities posted for residents to view. The facility has a 2-day perishable and a 7-day non-perishable amount of food. All residents requiring a special diet are posted for kitchen staff to review. LPA observed all medications, sharps, and cleaning supplies to be locked away and inaccessible to clients in care.