Facility Evaluation Report

Licensing Program Analyst (LPA), Hansen arrived at Tennessee Care, LLC unannounced for the purpose of conducting a Required-1 year inspection. LPA met with Jayson Sy, Licensee/Administrator.

This single story 4 bedroom facility is licensed for 4 non-ambulatory residents, with a Hospice Waiver for 2. LPA toured the building and grounds and found the home to be clean, organized, at a comfortable temperature with all exits free from obstruction. There are also, 2 bathrooms, living room, dining room, kitchen and garage. There was a 2 day supply of perishable and 7 day supply of non-perishable foods as per Title 22 regulations. Food stored in the kitchen refrigerator was properly stored as per regulations on this day at the time of the visit. Water temperature in the resident bathroom was found to be within appropriate range of 105-120 degrees F. Bathrooms were equipped with necessary grab bars, and slip-resistant mats, strips, or flooring in all bathtub and shower floors as required by Title 22 regulations. Cleaning products and knives are stored in key locked cabinets in the kitchen and locked cabinets in the garage. All bedrooms have lighting & appropriate furnishings per Title 22 regulations. Fire place, wood stove is observed with a screen/gate and licensee explained that it is not used.

A review of four resident & four staff records as well as two resident medications was conducted. LPA reviewed resident’s files at 8:45 AM on 8/14/2025 and learned that 4 of 4 residents have an updated reappraisal/needs & care plan, TB and physician’s assessments on file as required by Title 22 Regulation. Medications were centrally stored in locked closet in living room, overflow of medication in office cabinet.