Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Mary Joyce Nora and explained the purpose of the visit. There are currently four residents in care.

The facility is a one story home with three resident bedrooms, three bathrooms, one staff bedroom, kitchen, living room, dining room, laundry room, attached two car garage and backyard. Facility appears clean, safe and sanitary. LPA observed the kitchen to be free of debris and vermin. LPA observed the toxins to be stored under the locked kitchen and bathroom sinks and made inaccessible to residents in care. LPA observed the sharps to be in a locked kitchen cabinet under the oven and made inaccessible to residents in care. LPA observed a two day perishable and seven day non perishable food supply on hand. LPA observed all appliances to be operational. LPA observed a fire extinguisher located in the kitchen to be charged and with a service date of October 31, 2025. LPA observed activity supplies in the living room for resident enjoyment. LPA observed the laundry room toxins to be locked in a cabinet located above the washer and made inaccessible to residents in care. LPA observed that all resident bedrooms had the required components and furnishings. LPA observed the bathrooms to have toilet paper, paper towels and non slip mats in the shower. LPA observed the water temperature to be measured between 109.5 and 110.3 degrees Fahrenheit. LPA observed extra clean linens to be in the hall cabinet. LPA observed the staff bedroom to be locked and made inaccessible to residents in care. LPA observed the emergency food and water supply to be located in the locked garage. LPA observed the backyard to be free of debris and obstructions. LPA observed the backyard to have a shaded seating area for resident use. AD tested the carbon monoxide and smoke detectors and they were found to be operational. Continue on LIC809C