Facility Evaluation Report

On 3/2/26, Licensing Program Analysts (LPAs) Kyle Wellington and Janette Romero made an unannounced visit to the facility to conduct an annual inspection. LPAs met with the Administrator, Mark Melton, who was informed of the purpose of the visit. LPAs observed 2 (two) staff and six (6) residents present at the facility. The census at the facility is six (6) residents with one (1) of the residents receiving hospice care. LPAs received a LIC 9020 from the Admin. LPAs toured the inside and outside of the facility with the Admin. LPAs conducted an observation, interviews and record review at the facility for the inspection.

Facility Overview: The facility is a one story house with six (6) resident bedrooms, three (3) bathrooms, kitchen, family room, dining room, laundry room and attached garage. There are no pools, bodies of water or firearms at the facility. The facility has a fire clearance to serve five (5) non ambulatory and one (1) ambulatory residents. The facility has a hospice waiver for four (4) residents.

Infection Control: LPAs observed soap dispensers in the bathrooms and hand sanitizers in the facility. Cleaning supplies were locked in the garage and available for regular facility maintenance. LPAs reviewed the facility’s infection control plan which met the department’s requirements.

Physical Plant: LPAs observed the inside and outside of the facility to be clean, safe and well kept. The floors, windows and doors were clean and well maintained. The living room and dining room furniture was in good repair. The halls had night lights and were free of obstruction. The residents’ bedrooms were neat, organized and had the required bedding, furniture and lighting. Bathrooms were clean, tidy and contained handrails and non-slip mats in the shower. The hot water temperature in the bathroom was measured at 112