Facility Evaluation Report

On 02/28/2024 12:52 PM, Licensing Program Analyst (LPA) Regina Cloyd conducted an announced visit to the facility for purpose of a pre-licensing evaluation. An application was submitted to CCLD on 11/15/2023, for an initial license for a Residential Care Facility for the Elderly to serve the elderly for ages 60 years and older. The requested capacity is for five (5) ambulatory only. The facility has a hospice waiver for three (3).

Facility is a (4) bedroom, (2) bathroom, single story house with a (2) car attached garage. The facility has a kitchen, dining room, and living room. The home has a fireplace in the dining room with a metal screen cover and is inaccessible to residents. The residents' bedrooms are spacious and easily accommodate the residents' furnishings. There is a back yard with outdoor furniture and shade and a shed for storage. Passageways, walkways, driveways, steps and backyard are free from obstructions and hazards.

There shall be no more than two residents per bedroom. Bedrooms #1, #2, and #4 is for (1) ambulatory resident. Bedroom #3 is for (2) ambulatory residents. Bedroom #3 has two beds, two chairs, two night stands (with two drawers), and two lamps in addition to overhead lighting. It also has one dresser with five drawers and two closets.

All bathrooms have a working toilet, wash basin, and bathtub/shower. Night lights are in the hallways for bathroom #2.

Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen is stored in hallway closet.