Facility Evaluation Report

At 9:30am on 10/27/2025, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to conduct a annual facility inspection visit. LPA accompanied by Tri Counties Regional Center (TCRC), Quality Assurance Representative, Stephanie Cole (QA). QA and LPA met with Facility Administrator, Cindy Baker, announced who they are and the reason for the visit.

This facility is a five bedroom, three bathroom, one office, grand living room, dinging room, activity area, and an open nurses station adjacent to the living room. Medication are stored in a locked rolling medication cabinet. There is a completed first aide kit and ample medical supply to address the needs of residents in care. There is ample incontinence supplies and personal perfective equipment (PPE) supplies on hand. All resident rooms are equipped according to regulations. All bathrooms meet regulation requirements. Water temperature was tested and within regulation range of 105*-120*(f). There are fire extinguishers located throughout the facility that are all primed and in the green as working. There are smoke detectors that are dual carbon monoxide detectors in each room and are hard wired and green led indicating being functional. All hallways, passage ways and door ways are free and clear of obstacles. LPA noted that the garage door conversion is lacking dry-wall and appears unfinished at this time. LPA noted that the facility has at least seven days of non-perishable foods and at least two days of perishable foods on hand for five residents and staff. LPA noted that there is emergency water supply located in garage. LPA noted that this facility has a full function generator that automatically powers the entire facility in the event of a power outage. LPA noted that the facility was clean and in good repair. LPA conducted the full physical inspection with TCRC QA.

Administrator, QA and LPA conducted a full review of the annual care tools for this facility. LPA reviewed staff files, client files, Centrally Stored Medication Records, Emergency Disaster Plan and Infection control plan. LPA screen all employes to be fingerprint cleared. LPA noted that there were no violations or citations as a result of a full annual inspection. Exit interview, report read, and report provided.