Facility Evaluation Report

At 8:30 a.m. on 05/28/24, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the administrator and disclosed the reason for the visit.

LPA and administrator toured the facility inside and out at 9:15 a.m.

The facility was last visited on 01/23/24 for a case management visit. It is a single story building with five (05) bedrooms, five (05) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents, of which four (04) may be bedridden. Surveillance cameras were observed in common areas and on the facility perimeter. The front access is gated and requires a PIN code for entry. The front yard was well maintained. A centralized auditory alarm system was operational. Fire sprinklers were located throughout the facility.

At the main entrance, LPA observed postings for personal rights and the facility license. A sign-in sheet and hand sanitizer were available. Additional postings were observed inside for emergency contacts, emergency disaster plan, confidential complaint contacts, and administrator certificates. At approximately 9:30 a.m. LPA observed a fully charged fire extinguisher at the main entrance. It was last inspected on 12/11/23. Two other extinguishers were observed near the garage and in the kitchen. At approximately 9:45 a.m., smoke and carbon monoxide detectors were tested and operational.

The facility has five (05) bedrooms. Four (04) bedrooms are private, and Bedroom #1 is a shared room. All bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition. Bedroom #3 had a sign posted for “No smoking – Oxygen in use”.

The facility has five (05) bathrooms, two (02) of which were private. All bathrooms contained liquid soap, paper towels, trash can with a tight-fitting lid, grab bars near the toilet and shower, and a non-skid mat or non-skid surface in the shower. At approximately 10:30 a.m. LPA measured the water temperature in the private bathroom to Bedroom #1 to be 105.5 degrees Fahrenheit.