Facility Evaluation Report

At approximately 8:45 a.m. on 12/30/25, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with staff and later the licensee and disclosed the reason for the visit.

A file review was conducted prior to today’s visit.

The facility was last visited on 11/26/24 for a complaint visit. It is a single story building with five (05) bedrooms, three (03) bathrooms, kitchen, laundry room, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents, of which five (05) may be bedridden. Approved hospice waivers for five (05).

LPA observed a maintained front yard. Postings at the front and in the hallway included COVID precautions, facility license, confidential complaints contacts, ombudsman contacts, emergency disaster plan, rights of resident councils, personal rights, and the facility sketch.

Walls, floors, windows, screens, and blinds were clean and in good repair. At 8:55 a.m. LPA measured the room temperature to be 76 degrees Fahrenheit. Two (02) residents were observed in the dining room watching television. Two (02) staff members were observed cleaning and preparing lunch.

The living room contained a television, reading material, exercise equipment, and furniture in good repair. A fireplace was appropriately covered and turned off. Medications were locked near the main entrance and under the counter.

The facility has five (05) bedrooms. One (01) bedroom is designated as a staff room. The staff room was unlocked and free of hazards.