Facility Evaluation Report

At approximately 9:00 a.m. on 03/19/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the licensee and administrator and disclosed the reason for the visit.

A file review was conducted prior to the visit. The facility was last visited on 03/09/245 for an annual inspection. It is a single story building with five (05) bedrooms, three (03) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for five (05) nonambulatory residents and one (01) bedridden resident in Bedroom #5. The facility serves residents with dementia. Approved hospice waivers for six (06).

At the main entrance, LPA observed postings for the facility license, facility sketch, administrator certificates, COVID precautions, emergency disaster plan, visitation policy, a blank copy of an admission agreement, nondiscrimination notice, rights of resident councils, personal rights, ombudsman contacts, confidential complaint contacts, and the theft and loss policy. A sign hung on the main entrance and Bedroom #4 to indicate “No Smoking – Oxygen in use”. A screening station at the front contained masks, hand sanitizer, and a visitor’s log.

Walls, floors, windows, screens, and blinds were clean and in good repair. At 9:20 a.m. LPA measured the room temperature to be 72.0 degrees Fahrenheit. A linen closet in the hallway contained adequate supplies of fresh linens. A locked cupboard contained a complete first aid kit. The front living room contained a piano, furniture in good repair, and a fireplace which was appropriately covered. Around 9:30 a.m. two (02) staff were observed engaging three (03) residents in exercise in the living room. A fourth resident was observed solving a puzzle in the dining area.