Facility Evaluation Report

On 07/27/2024 at 09:14 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were two (2) staff present, and four (4) residents present. Licensee/Administrator Jennifer Hahn was contacted and informed of the visit. Licensee/Administrator Hahn arrived during the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator Hahn.

The facility is a six (6) bedroom, four (4) bathroom home with a kitchen/dining area, living room, activity room, laundry area and garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which six (6) can be bedridden. The facility has six (6) Hospice Waiver. The current census is four (4) residents. LPA Brown was accompanied by Staff #2 (S2) and Licensee/Administrator Hahn to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPA Brown observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit (F). LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, lamps and storage space. LPA Brown observed sufficient lightning. Moreover, LPA Brown observed that bathrooms were clean, and appliances were operating appropriately. LPA Brown observed grab bars and non-skid mat in the resident bathrooms. During the tour of the facility, LPA Brown observed Resident #2 (R2), has half bed rails. Licensee/Administrator Hahn reported to LPA Brown that R2 does not have written order from their physician indicating the need for half bed rail for mobility. Deficiency will be issued.