Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by receptionist. LPA met with Patricia Miller, Executive Director and LPA explained the nature of the visit. Facility is licensed for 72 non-ambulatory residents, of which 17 may be bedridden. Facility has an approved hospice waiver for 15 residents. There are 12 residents currently on hospice during today's visit. This facility consists of a memory care unit which are protected by delayed egress exits.

LPA Martinez along with Executive Director toured the inside and outside of the physical plant of the memory care unit. LPA observed three dining halls for residents. LPA observed menus mounted on the wall and the food offered is varied and healthful with an everyday optional menu. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Maintenance records were observed in the main kitchen. During the tour LPA observed residents having lunch in all the three dining areas. LPA inspected that medication is centrally stored in a safe locked location; facility has a medication room. LPA observed and inspected medication carts that are used to dispense meds to residents and observed medication was labeled and stored inaccessible to residents in care. Facility has 4 bedroom wings and resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and shower was free of mold/mildew. Various resident bathrooms were tested for water temperature and water temperature measured between 109 and 115.3 degrees F in tested bathrooms. Facility has common showers and bedrooms have a full bathroom or half bathroom in each room. Resident