Facility Evaluation Report

At 1:40 p.m. on 07/09/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the administrator designee and disclosed the reason for the visit.

The facility was last visited on 11/06/2023 for an annual inspection. It is a single story building with seven (07) bedrooms, five (05) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (06) residents, of which five (05) may be non-ambulatory and one (01) bedridden in Bedroom #6. The facility serves residents with dementia. Approved hospice waivers for six (06).

At the main entrance, LPA observed a visitor’s log, hand sanitizer, and postings for confidential complaint contacts, Ombudsman contact information, personal rights, rights of resident councils, neighborhood policy, house rules, facility sketch with evacuation routes clearly labelled, emergency disaster plan, admission agreement, administrator certificate, and the facility license.

Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. Two (02) residents were observed watching television in the living room. A piano, reading material, and activities were available in the living room as well. Sufficient amounts of fresh linens, emergency water, and hygiene supplies were stored in the hallway cabinets. Cameras were used in common and exterior areas. At approximately 2:15 p.m., five (05) out of five (05) auditory alarms were tested and deemed operational.

All emergency exit paths were free from obstructions. The exit gate was unlocked with a self-closing latch. At approximately 2:30 p.m., the dual-purpose smoke and carbon monoxide detector in the hallway was tested and operational. When tested, three (03) out of three (03) detectors were heard and the fire door in the living room released from its magnetic suspension.