Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 6/17/24 at 8:45am to conduct a Case Management - Health Checks visit. LPA met with Joan Young, Caregiver then Beatrice Clark and stated the purpose of the visit. The Administrator certificate for Beatrice Clark expires 10/30/25. LPA observed the facility is licensed to serve 6 non-ambulatory residents in rooms 3-5 and the master bedroom of which 2 may receive hospice care services. There is 1 residents receiving hospice care services at this time. During LPA visit the temperature inside the facility measured to be at 73*F which is within the required range of 68-85*F. LPA observed caregiver(s) performing other duties during this visit. LPA observed fire extinguisher, smoke alarm, carbon monoxide detector in the home. LPA observed 2 day perishables. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide.

*License fees not paid that was due on 5/3/24. Pin number was given as an option to pay online to become current.

*The water temperature measured at 143.7*F which is within the required range of 105-120*F.

*LPA observed the centrally stored medications area to be unlocked and accessible to residents, on table in room 1 with 2 residents present in bed

*Medications are stored with chemicals in garage

*Resident #1 (R1) was requesting to be dressed and staff #1 (S1) stated you are not going anywhere and that R1 always ask for the pants.

*S2 does not have a file available for review during the visit

*Administrator/S2 does not have fingerprint clearance or association documentation