Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA met with Greg Tillman, Administrative Assistant and explained the purpose of the visit. LPA was informed that the Administrator, Ian Baker is out on vacation. There are currently thirty four (34) residents 60 years and older residing in the facility. Facility is licensed to serve elderly residents age 60 and above, fire clearance approved for (72) non-ambulatory. Hospice appr oved for ten (10) residents, 87705 compliant. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor sign-in station located in the main entrance lobby. The facility has an Infection Control Plan. Staff are adhering to infection control requirements. Emergency and disaster plan was completed and up to date. Infection control practices and Personal Protective Equipment (PPEs) were maintained.

Operational Requirements: The Infection Control Plan has been added to the Plan. Facility is approved for (10) hospice residents, 87705 compliant. A fire clearance is in place. Fire Drill was last conducted on 3/07/2025. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place and expires 01/01/2026. Surety bond is in place.

Due to time constraints, LPA was unable to complete the following domains and will return at a later date to complete this required- 1 year inspection.

No deficiencies were observed during the visit. Exit interview held and a copy of the report was provided to Greg Tillman, Administrative Assistant.