Routine inspection·June 20, 2022

Licensing Program Analyst (LPA) Wendell Smith conducted an annual required visit. LPA met with staff and explained the reason for this visit. A tour of the physical plant was conducted with staff at 12:20pm; the LPA inspected facility for Fire Safety, Personal Accommodations and Services, Medication Procedures, and Food Service. The following was noted: Facility is a single story residential home with four (4) bedrooms and two (2) bathrooms. There is one additional bedroom designated for staff use. Facility has dementia residents. All exit signal alarms were tested and function properly. Smoke detectors and Carbon Monoxide detector were tested and functioned properly during time of visit. Kitchen: The kitchen appeared clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects are stored in a locked drawer in the kitchen. Medication is stored in locked cabinet in the kitchen area. Bedrooms: The resident bedrooms were properly furnished with at least one chair, night stand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Bathrooms: LPA observed all bathrooms were clean, properly supplied and had functional fixtures. LPA observed grab bars and non-skid mats in all bathrooms . Residents have sufficient amounts of supplies for personal hygiene. The hot water was measured in each bathroom during physical plant tour. Hot water measured within the required limit of 105-120 degrees Fahrenheit in all bathrooms during visit. Common Areas : These included the living room and dining area. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. No deficiencies cited. Exit Interview conducted.