Facility Evaluation Report

Licensing Program Analyst (LPA), Regina Cloyd, conducted an announced visit to the facility for purpose of a prelicensing evaluation. An application was submitted to CCLD on 09/24/2024, for initial license for a Residential Care Facility for the Elderly to serve the Elderly for 60 years and older. The requested capacity is for six (6) non-ambulatory. The facility has an approved hospice waiver for four residents.

Facility is a six (6) bedroom, two (2) bathroom, single story house. There is a large covered front porch and driveway that leads to the back porch with ramp.

Bedrooms #1 - 6 are for non-ambulatory residents. Bedroom #2 has two beds, two chairs, two night stands/dressers, and two lamps in addition to overhead lighting. There are two dressers with three drawers and currently one closet. Bedrooms 1, 3-4, & 6 are currently setup as private rooms. Bedroom #5 is currently being used as a storage space.

Both bathrooms have a working toilet, wash basin, and step-in shower. Bathrooms will accommodate non-ambulatory residents in a wheel chair.