Routine inspection·May 8, 2024

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 which includes one bedridden resident. The Administrator confirmed there are six residents living in the facility. LPA and the Administrator began the tour of the facility at 9:30 am until 10:20 am. 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. Bathrooms – LPA Spaeth observed the bathrooms contained hand soap, grab bars, slip resistant mats, paper towels, and a trash can. The water temperature was tested at 10:30 am and was 126 degrees F. The Administrator turned down the water heater temperature at 10:35 am. Bedrooms – LPA Spaeth observed there are five 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 / Garage – LPA Spaeth observed the laundry room was not locked and LPA observed medications were located in the unlocked area. The Administrator stated the medications were the Administrator's personal medications. LPA Spaeth advised the Administrator to lock the medications. At 10:15 am, LPA observed the Administrator locked the medications in the office room. LPA observed the washer and dryer were located in the room. The laundry detergent was locked in a room within the laundry room. LPA observed an additional staff room was located in the garage area. Hallway Closet – LPA Spaeth observed a hallway closet contained additional clean linens. LPA observed another locked closet which contained additional PPE and hygiene items. 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 10:30 am and are operational. . LPA reviewed resident's records at 10:45 am until 11:45 am. LPA reviewed the staff records at 11:45 am until 12:15 pm. The following deficiencies were issued (refer to LIC809D). Exit interview conducted, appeal rights given, and a copy of the signed report was given to caregiver.