Facility Evaluation Report

On 7/16/2026 at 11:44 AM, Licensing Program Analyst (LPA) LaVette Farlow arrived unannounced to conduct the required annual visit to the facility. LPA met with House Manager Sandy Barr, and introduced self and stated purpose of the visit. LPA was informed the current census is five (5) two (2) residents were present during the visit two (2) resident were at InnovAge Day Program, and one (1) resident was visiting with family.

The facility has 4 bedrooms, 2 1/2 bathrooms, 1 staff bedroom, kitchen, dining area, family room, living room, washer and dry in the garage, attached garage, and backyard. LPA completed a walk through of facility, review of records, and medication.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected client bathrooms; bathrooms were clean and appliances were found functional. During the inspection LPA observed cleaning supplies under the bathroom sink in the staff bathroom by the kitchen. The cabinet was unlocked and not secured with chemical spray bottle and can of Ajax unsecured. A Deficiency cited. The water temperature was tested and measured at 115.5, 107.1 and 113.3 degrees Fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms and charged fire extinguisher, the last fire extinguisher inspection was conducted 7/17/2025. Posters such as; the personal rights, CCL complaint poster and disaster plans were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept secure and inaccessible to residents. There was a designated storage space for residents/staff files. Medications and first aid kit were observed secure and inaccessible to residents. The facility has emergency food and emergency to go backpacks for residents in care. There are no firearms or ammunition in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care.

Food Service : Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a wide variety of food available for residents. Dishes, cups, and utensils were also stored properly. Emergency food and water were also observed.