Facility Evaluation Report

Licensing Program Analysts (LPA) Bernadette Allen made an unannounced visit to the facility to conduct an annual inspection. At the time of the visit there was one (1) staff members and one (1) resident. LPA met with Diane Emerson- Licensee who was informed of the purpose of the visit.

Upon entering the facility Diane informed LPA there was no power. Diana stated she received notification by e-mail which was observed at the time of inspection which stated services would be intermittently interrupted because of weather conditions. Diana also stated all responsible parties for Resident 1 (R1) have been informed of the outages in the community and the emergency disaster plan will be implemented if required.

LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: The Indoor and outdoor passageways were kept free of obstruction. The facility has sufficient furniture and is maintained at a comfortable temperature.

There was enough nonperishable and perishable food for the number of resident in care. The facility has a variety of food available for resident. The facility food is stored in a safe manner. Sharps are stored and locked cabinet in the laundry room inaccessible to resident in care.

The resident bedroom is equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting.

All bathrooms had non-slip mats and were operating in a safe and in good sanitary condition. The hot water temperature measured between 105-120-degrees F. LPA also observed the facility is equipped with operating carbon monoxide/smoke detectors and fully charged fire extinguishers.

Posters such as personal rights and the disaster plan were posted in a common area.

LPA did observe cleaning supplies, toxins items are kept in a locked cabinet in laundry room inaccessible to resident in care. The resident file was reviewed, all files had the required documents at the time of the visit.