Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a post-licensing inspection. LPA met with Licensee, Tess Hayes. All clients were attending to Day Program.

At 12:30pm LPA/Licensee toured building and grounds which were found to be clean and in good repair. Exits and walkways were free from obstructions. Facility had sufficient perishable and non-perishable food. Facility has first aid kit which was found to be appropriate during the Post-Licensing inspection. There is outdoor space for activities. LPA observed activity calendar and weekly menu. All resident’s bedrooms have lighting & appropriate furnishings, and resident’s beds were outfitted with mattress pads as required by regulations. Carbon monoxide and smoke detectors were present throughout the facility. Fire extinguishers inspected were charged and current as of September, 2023. Cabinets designated for cleaning supplies and other items that could pose a risk had locks. A locked closet is designated for medication and files. Last disaster drill was conducted on February 15, 2024. Hot water temperature measured at 115.7 degrees in resident's bathrooms which is within regulation. Bathrooms had necessary grab bars and non-slip mats. Medications were centrally stored and secured. During today's post-licensing inspection, LPA reviewed three residents and two staff files. Residents have current medical assessments and individualized care plans. Staff records indicated that CPR/1st aid and staff have received required annual training hours. Admission agreements were updated indicating the change of ownership. Administrator certificate for Tess Hayes 6037085735 expires August 19, 2025. Required postings observed.

No citations issued during today's visit. Exit interview was conducted with Licensee and a copy of this report was given.