Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Wallace conducted a Required 1 Year Annual Inspection. LPA explained purpose of visit with assistant administrator. LPA had temperature checked at the entrance of the facility, questioned for any COVID-19 symptoms, and then was allowed entrance. LPA explained the purpose of the visit with assistant administrator.

LPA Wallace toured the one floor facility with the administrator and two staff members present in the facility. The garage is used to store restroom essentials. The washing machines and essential cleaning solutions were in their own locked storage area. The facility also included a storage area of games and activities for residents. No obstructions blocking indoor and outdoor passageways observed. No pools or bodies of water observed. Hot water temperature was measured at 109.8 degrees Fahrenheit in kitchen sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. The facility's kitchen was free of debris. Knives and additional cleaning solutions were locked. LPA observed the facility's restrooms as clean and equipped with hand washing signage. The facility's backyard was free of debris and fenced. LPA toured the staff room, which was its own restroom. LPA also observed the locked medication room.

The residents' bedrooms were inspected and all had required lighting and furniture.

Facility was equipped with smoke detectors and carbon monoxide detectors. LPA also observed the fire extinguishers last inspected on 8/25/2022. The facility's first aid kit included the required tweezers, scissors, and a thermometer. The facility's PPE supply was presented to the LPA as sufficient. The facility adhered to the seven day non-perishable and two day perishable food supply.

The facility is equipped with a fire alarm system and a sprinkler system. The facility also submitted their COVID-19 Epidemic Outbreak Mitigation Plan.

LPA reviewed three (3) resident files and two (2) staff files. A review of staff records indicates that all facility staff & other individuals who require caregiver background checks are fingerprint cleared and to the facility. LPA verified staff training for staff file reviews and all 2 staff have current First Aid Certificates.

No deficiencies were found or cited during today's inspection visit. Exit interview held with administrator and a copy of report given at the conclusion of the visit.