Facility Evaluation Report

Licensing Program Analyst (LPA), Javina George, conducted an unannounced visit to the facility for a required annual inspection. LPA was greeted and granted entry and met with Administrator, Garrett Welker. LPA informed the Administrator of the purpose for the visit. The facility currently has an approved Hospice Waiver for six (6) residents, there is currently one (1) residents receiving hospice services. There are no residents receiving home health services.

The facility is a two story structure consists of six (6) resident bedrooms, one (1) staff room, a dining area, and backyard with a gazebo. The first floor of the facility consists of staff rooms and independent living resident room. There are no bodies of water located on the property, or known guns and ammunition on the premises. The sharps, chemicals and hazardous items were observed to be locked and inaccessible to residents in care. The resident medications are locked inside medication carts inside the staff office. All outdoor and indoor passageways are kept free of obstruction. The carbon monoxide and smoke detectors were tested and observed to be operable. The facility is conduct emergency disaster drills on a quarterly basis, the last drill was conducted on 5/1/25.

LPA observed for the food supply to be sufficient . There is a minimum of 2 days supply of perishable foods and 1 week's supply of non-perishable food items. All staff present were observed to have criminal record clearance and to be associated to the facility. Staff present were also observed to have current first aid and CPR training. However there was no proof of initial or going training available to review, therefore a citation was issued. The resident files had the medical assessments, and appraisals.

The facility annual fees that were due on or before 5/18/25 were paid during today's visit. While in bedroom #6 LPA observed for part of the shared fence facing, in the backyard to have fallen over. Per Administrator