Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced continuation of the Required 1 Year visit from 5/30/2025. LPA Rai met with Executive Director, Bradley Burgoyne and stated the purpose of today's visit.

During visit, LPA Rai toured the inside and outside of the facility. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents.

LPA Rai toured the facility to include 5 resident rooms, dining room, activity room, kitchen and memory care unit. 5 Out of 5 resident bedrooms had available bedding, drawers, and functioning lights. The facility bathroom had available soap, paper towels, and trash cans with lids. The hot water temperature in the bathroom sinks ranged from 111.6 - 113.7 degrees F.

LPA Rai observed 1 prescription medication located in the bathroom mirror cabinet wall mounted above the sink in Resident R5's Room. Staff (S1) stated the medication should not be present in R5's room and R5's medications should be locked and inaccessible to resident. Based on review of R1's LIC 602A Physician's Report 3/6/2025, R1 has neurocognitive disorder and R1 is not able to administer own prescription medications, and not able to store own medications.