Facility Evaluation Report

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by concierge. Interim Department of Health Services (DHS) Faveola York worked with LPA until Administrator (Admin) arrived. Administrator Grant Haywood arrived later. Grant Haywood Administrator Certificate 7039094740 expires 8/6/26. All fees are current as of this time. Fee notification given to Admin along with PIN for online payment. Facility currently has 42 residents in care nine (9) of which are currently on hospice.

At approximately 9:30am LPA and DHS toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled with opened dates present. LPA observed kitchen cleaning products located on a shelf very back of kitchen, away from food preparation. LPA and Director of Dining Services (DDS) discussed adding a cabinet in which to store the disinfectants and cleaning products utilized in the kitchen. DDS will request from Admin immediately. All other cleaning supplies and laundry soaps are located in the laundry room or in cleaning carts, inaccessible to residents in care.

LPA and DHS toured room # 3, #10, and #17. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperature in sinks measured at 116.4 degrees F in room #3, 115.2 degrees F in room #10, and 114.4 degrees F in room #17, all of which are within the allowable range of 105 to 120 degrees F. Facility has common bathrooms used by residents, staff, and guests. Faucets in these bathrooms are turned on by hand sensor. Hot water is an