Facility Evaluation Report

On 8/01/2022, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Infection Control Inspection. LPA introduced self and allowed entrance by Direct Care Staff, Tori Morgan Allison. LPA was screened for COVID and observed visitor sign in available. Staff observed to be wearing masks. Kevin Allison serves as facility Administrator, Certificate #6011200735, expires 1/17/2024.

Tour of the facility conducted with Tori Morgan Allison. Adequate seating and lighting available in all common areas of the facility. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available. All medications is locked and secured in kitchen cabinet. Residents have a 30-day supply of medication available. Residents all have private bedrooms. Resident bathrooms toured, LPA observed paper towels and hand soap available. First Aid Kit available. Carbon monoxide and smoke detectors observed operational. Fire extinguisher is current. Water temperature measured at 140 degrees F.

Outside of facility toured, no obstructions observed. Pool is surrounded by a fence and is locked and secured.

Exit interview conducted. Facility report signed during inspection and a copy provided for facility records.