Routine inspection·October 30, 2024

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregivers. The Administrator Amy Frey arrived at 10:15 am. LPA stated the purpose of the visit was to conduct an annual inspection. The Administrator confirmed there are five residents. The facility is licensed for five (5) non-ambulatory residents and one bedridden resident. LPA Spaeth and the Administrator toured the facility at 10:30 am until 11:05 am. Common Areas – The family room, dining room, and kitchen are combined. The family room was furnished with comfortable seating and a television. The dining room area contained a dining room table and chairs. Kitchen - LPA Spaeth observed a two-day supply of perishable food and a seven day supply of non-perishable food. The knives were locked. The cleaning solutions were locked underneath the kitchen sink. The fire extinguisher is located in the kitchen and is operable. Medications: LPA observed the resident medications, first aid kit, and PPE supplies were safely locked in a hallway closet. Continued on 809-C Garage /Staff Room – The door leading into the staff room and garage area was not locked. LPA observed the washer/dryer are located in the garage and additional cleaning solutions along with the laundry detergent were stored in the garage. During LPA's tour, the door leading to the area was locked by staff. Resident Rooms: There are four resident rooms which were furnished with a bed, linens, night stand, lamp and chair. The rooms were neat and clean. Bathrooms: There are two (2) bathrooms in the facility. The bathrooms contained hand soap, paper towels, grab bars, trash can, and slip resistant mats. Water Temperature : The water temperature was recorded to be 105 Degrees F at 10:15 am. Additional Hallway Closet - LPA observed the clean linens were located in a cabinet. Surrounding Grounds : There were no visible hazards, and passageways were free from obstruction. The side gate of the house was closed and was not locked. Comfortable seating is also located in the backyard. Smoke/Carbon Monoxide Detectors : The smoke and carbon monoxide detectors were tested at 11:40 am and were operable. LPA Spaeth reviewed the resident files at 11:40 am until 12:15 pm and reviewed the staff staff files at 12:15 pm until 12:45 pm. LPA reviewed the medications at 1:05 pm until 11:15 pm. The following deficiency was issued. Exit interview conducted, appeal rights discussed, and a copy of the signed report was given.