Facility Evaluation Report

At 9:05 a.m. on 10/05/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with staff and later Administrator and disclosed the reason for the visit. LPA and staff toured the facility inside and out.

The facility was last visited on 08/10/2022 for a complaint visit. It is a single story building with 4 bedrooms, 2 bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for 4 ambulatory residents.

LPA observed a maintained front yard. Signs for the facility’s visitation and masking policies were hung on the front door. Other postings inside included administrator certificate, facility license, confidential complaint contacts, Emergency Disaster Plan, personal rights, monkeypox precautions, COVID precautions, neighborhood complaint procedure, and activity schedule. LPA was screened for infectious disease upon entry. The screening station contained a visitor log, digital thermometer, surgical masks, N95 masks, gloves, hand sanitizer, and sanitizing wipes. The visitor log tracked temperature, symptoms, and vaccination status.

Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. At 9:31 a.m. LPA measured the room temperature to be 74 degrees Fahrenheit. The hallway contained 2 linen closets with adequate supplies of fresh linens. LPA observed a sufficient supply of perishable and non-perishable foods in the kitchen. Appliances were sanitary and functional. Sharps were locked above the countertop. A laundry area was located by the kitchen. LPA observed a washer and a dryer in working condition. Detergents and cleaning solutions were locked above the washer.

The facility had 4 bedrooms. All bedrooms were private, and one bedroom was designated for staff. The staff bedroom was locked and free of hazards. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition.