Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation and Case Management visit. LPA was greeted and granted entry by Staff #1 at 1:05pm. LPA met with Administrator (AD) Heddy "Girlie" Mae Oyson and explained the purpose of the visit.

The facility is a single story, four bedroom residence with an approved fire clearance of six non-ambulatory residents of which one may be bedridden. The licensee has an approved hospice waiver for six. The facility currently has a census of five residents in care and all five residents receive hospice services.

During today’s visit, LPA toured the facility and inspected and tested all smoke detectors. Smoke and carbon monoxide detectors were operational. The temperature in the facility was 76 degrees. All utilities such as air conditioning, gas, water/trash were operational The facility has two bathrooms but one bathroom is designated for residents; the other bathroom is off the kitchen and is only used by staff. LPA tested the hot water temperature in the resident bathroom. The hot water temperature measured 106.8 degrees Fahrenheit. The bathroom had grab bars and covered trash cans.

LPA observed the fire extinguisher was charged and was serviced on October 4, 2024. The facility’s last fire drill was conducted on February 8, 2025 and a deficiency will be cited. A fire drill in-service was conducted during LPA's visit. LPA inspected the kitchen and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand Additional food is stored in the garage with emergency supplies. Sharps and knives were secured in a locked drawer and chemicals and cleaning supplies were secured underneath the kitchen sink. The PUB 475 poster was observed in the kitchen. LIC 500, Infection Control, Visiting Hours, Facility sketches and Disaster Plan (Continued on LIC 809-C)