Routine inspection·November 2, 2023

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit and was greeted by a caregiver and the Administrator. The facility is licensed as an adult residential facility for the elderly to serve three ambulatory residents, three non-ambulatory and one bedridden resident. LPA reviewed resident's records at 10:10 am until 10:35 am and reviewed staff records at 10:35 am until 11:10 am. LPA and the Administrator began the tour of the facility at 11:45 am until 12:25 pm. LPA observed the following: Living Room – LPA Spaeth observed the living room contained comfortable seating and a television. Kitchen/Dining room - The dining room and kitchen are combined. LPA Spaeth observed a seven-day supply of non-perishable food and a two-day supply of perishable foods. The fire extinguisher is located in the kitchen. LPA observed the knives were locked in a kitchen drawer, and the cleaning solutions were locked in a cabinet underneath the sink. The water temperature was tested at 12:19 pm and the temperature was 107.0 F. Bathrooms – LPA Spaeth observed the bathrooms contained hand soap, grab bars, paper towels, and a trash can. Bedrooms – LPA Spaeth observed there are six residents' bedrooms in the facility. The bedrooms contained bed, linens, night stand, chair, chest of drawers, and a night lamp. Staff Room – LPA observed the staff room was locked. Cont'd 809-C Laundry Room – LPA Spaeth observed the laundry room was locked and contained a washer and dryer along with the laundry detergent. Hallway Closet – LPA Spaeth observed the hallway closet contained additional clean linens Garage - LPA observed PPE supplies and an additional refrigerator with additional food Backyard – LPA Spaeth observed comfortable seating in a shaded area. A locked gate surrounds the pool. The side gate leading from the backyard to the front yard was not locked. Smoke/Carbon Monoxide Detectors – The smoke/carbon monoxide detectors were tested at 12:15 pm and are operational. . There are no deficiencies at this time. Exit interview conducted, and a copy of the signed report was given to caregiver.