Facility Evaluation Report

At 12:20 p.m. on 02/09/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with staff and later the administrator and disclosed the reason for the visit. LPA and administrator toured the facility inside and out at 12:50 p.m.

A file review was conducted prior to the visit.

The facility was last visited on 01/17/2023 for a prelicensing inspection. It is a single story building with four (04) bedrooms, two (02) bathrooms, kitchen. garage, common areas, and outdoor areas. It has an approved fire clearance for four (04) residents, of which three (03) may be nonambulatory in Bedrooms #1, #2, and #3, and one (01) ambulatory in Bedroom #4.

At the main entrance, LPA observed postings for the administrator certificate, facility license, facility sketch, confidential complaint contacts, personal rights, house rules, staff list, resident list, emergency contacts, grievance policy, and COVID precautions. A screening station was present near the front and contained a digital thermometer, masks, sanitizer, and a visitor log.

LPA observed an adequate supply of perishable and non-perishable foods in the refrigerator, freezer, and pantry. The stove hood was clean. Appliances were in good condition. A weekly menu was posted on the refrigerator. Sharps were locked below the sink. Medications were locked above the counter top.

The garage was locked and contained an operational washer and dryer, emergency water, locked detergents and cleaning supplies, and an extra refrigerator.

Walls, floors, windows, screens, and blinds were clean and in good repair. At 1:00 p.m. LPA measured the room temperature to be 72.0 degrees Fahrenheit. The living room contained a television, video game console, and furniture in good repair. A fireplace was turned off and appropriately grated. A linen closet at the end of the hallway contained adequate amounts of fresh linens and towels.