Facility Evaluation Report

On 7/18/2023 at 10:30 am, Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced required annual visit and was greeted by the Administrator. LPA Spaeth confirmed there are five non ambulatory residents with one bedridden and two Hospice residents. The facility is licensed as an RCFE to serve six residents of which six may be non-ambulatory and two may be bedridden. There is a hospice waiver

Kitchen – LPA observed a seven-day supply of non-perishable food and a two day supply of perishable food items. At 9:55 am, LPA observed the cleaning supplies were securely locked underneath the kitchen sink and the knives were locked in a kitchen drawer. The medications are locked in a kitchen cabinet and LPA also observed the first aide kit. A fire extinguisher is also located in the kitchen area.

Backyard – LPA Spaeth observed the delayed egress alarm leading out of the sliding glass door to the backyard was properly working. The backyard is a shaded area which contained comfortable seating. The side gate leading from the backyard to the front yard was not locked.

Bedrooms – LPA Spaeth observed there are two residents living in the master bedroom. The delayed egress alarm leading from the bedroom to the backyard was properly working. The room contained bed, linens, night stand, and night lamp. LPA also observed the other three bedrooms also contained the required bed, linens, night stand and night lamp. The delayed egress alarm properly worked throughout the facility.

Bathrooms – At 10:15 am, LPA tested the water temperature in the resident’s bathroom and LPA observed the reading was 106.7 degrees F. LPA Spaeth observed both bathrooms contained slip resistant mats, hand soap, paper towels, and trash can.