Facility Evaluation Report

Unannounced Annual Licensing visit made out to this facility on 02/19/2025 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Brandon Rose, at this time. A brief interview was conducted with the facility designated Administrator at this time.

This facility is licensed to serve up to (6) Non Ambulatory residents at any given time.

It was learned that there were (2) residents under the care of hospice at this time. This facility was approved to be able to accept and retain up to (4) residents at any given time.

It was learned that there was (1) resident deemed to be bedridden at this time. The facility was approved to be able to accept and retain up to (1) resident deemed to be bedridden at any given time.

A tour of the facility kitchen area was conducted. Drawers and cabinets were opened and the items enclosed were reviewed at this time. Drawers housing knives and sharps were observed to be locked and made inaccessible to the residents at this time.

Cleaning agents, bleach, and other supplies were observed to be locked and made inaccessible to the residents at this time.

A review of the facility food supply was conducted. A review of the facility's 2-day perishable foods and 7-day nonperishable foods was conducted to make sure that there were sufficient quantities on hand at all times.

Medication cabinet, located in the kitchen cabinet, was reviewed. Policies and procedures involving handling, dispensing, and documentation of the resident medications were discussed with the facility designated Administrator member at this time. A review of the facility Medication Administration Record and dispensing log was conducted.

Medication cabinet was observed to be locked and made inaccessible to the residents at this time.

Living room, dining area, and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time and able to meet the needs of the residents.