Facility Evaluation Report

On 10/29/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the community to conduct an annual inspection. LPA Campbell met with Ryan Hust, Executive Director and explained the purpose of the visit. The community is a 3 story facility licensed to serve 313 nonambulatory and 64 ambulatory residents over the age of 60. During this visit, Executive Direction Ryan Hust assisted with the tour of the facility and obtaining requested documents.

LPA Campbell toured the facility and inspected the physical plant including but not limited to the common areas, kitchen, dining area, client bedrooms and bathrooms, outside courtyards of the facility to ensure compliance with Title 22 regulations. Upon entry, LPA Campbell observed residents socializing, relaxing in their rooms and walking outdoors. LPA Campbell observed sufficient seven-day non-perishable and two-day perishable food supplies. The temperature for walk in freezers was 0 degrees Fahrenheit (F) or lower. The temperature for the refrigerator was 35 degrees F. Throughout the facility, LPA Campbell observed fire extinguishers that were last inspected 01/04/2025 and were fully charged. The kitchen ANSUL system was last inspected 09/30/2025. When the fire drill log was reviewed, LPA Campbell observed that Fire and Internal Disaster Drills were conducted once a month.

LPA Campbell observed an indoor pool accessible to Independent and assisted Living residents per staff. Residents use key fobs to access the pool and there are no staff supervising residents who use the pool. Upon entry, LPA Campbell observed one resident floating in the pool, and one resident in the whirlpool. No staff were present. There was also a sauna, steam room and bathrooms available for use. LPA Campbell reviewed several appraisals and no statements were found identifying residents who could use the pool with or without supervision.