Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 (S1) at 1pm. During today’s visit, LPA spoke with the Administrator, Shirley Hills, via phone. Administrator gave permission for staff to sign the report.

The facility is a five bedroom, two bathroom single story residence with an approved fire clearance of six non-ambulatory residents; of which all may be bedridden . The facility is approved with a hospice waiver for six residents. The facility currently has a census of five residents in care.

During today's visit LPA toured the facility and tested the smoke and carbon monoxide detectors. All detectors were operational. LPA observed the two fire extinguishers were charged and inspected on December 8, 2025. The facility conducted a fire drill on September 10, 2025. LPA observed the First Aid Kit had all the required elements and the facility had a First Aid book on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed.

While touring the kitchen, LPA observed two-days of perishable items in the refrigerator and seven-days of non-perishable items in the freezers and pantry. Emergency supplies and water were observed in the garage. All appliances, including washer and dryer, were in working order. Chemicals were secured and locked in the laundry room. Sharps and knives were secured in the medication storage.