Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to conduct the annual required visit. LPA was greeted and granted entry into the facility and explained the reason for the visit. Facility is licensed for 6 clients, 4 ambulatory and 2 non-ambulatory. The facility currently has 3 clients in care. Mitra Dixon has an Administrator Certificate expiring on 04/09/2027. The facility appears clean and sanitary.

LPA Lyman along with Care Staff Elizabeth Jones toured the facility at 10:02 AM. LPA toured the physical plant, checked food service, and reviewed facility documentation. The home consists of four client bedrooms, one shared hall restroom, client restroom, living room, dining room, and kitchen. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Client bathrooms were checked. Toilets and water faucets worked properly and shower was free of mold or mildew. Water temperature measured between 111.3 and 113 degrees F in facility restrooms. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including thermometer and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors and Carbon Monoxide detectors tested operational during today's visit. Fire extinguisher is fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating for clients as well as a fenced pool. Exit gate is unlocked and self latching. LPA observed the latch on the gate is broken. LPA observed facility does not have emergency food or water. Facility does not have documentation of quarterly fire drills. CONTINUED ON LIC 809C DATED 09/13/2025.