Routine inspection·October 6, 2022

At 11:35 p.m. on 10/06/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out. The facility was last visited on 06/13/2022 for a complaint visit. It is a single story building with 4 bedrooms, 2 bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for 5 nonambulatory residents, of which 1 may be bedridden in Bedroom #3. Approved hospice waivers for 2. Cameras are used in common areas. Upon entry, LPA a resident sitting outside in a maintained front yard. The front yard is gated. The ramp leading up to the main entrance was in good condition. Signs posted at the main entrance indicated the facility’s masking and visitation policies. LPA was screened for infectious disease upon entry. The screening station contained a digital thermometer, surgical masks, sanitizing wipes, hand sanitizer, and a visitor log. The visitor log tracked temperatures, and the Administrator stated vaccination status and symptoms are documented and retained. Other postings inside included Ombudsman contacts, confidential complaint contact, personal rights, emergency contacts, rights of resident councils, COVID precautions, activity calendar, facility sketch, and facility menu. Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. At 11:50 p.m. LPA measured the room temperature to be 79 degrees Fahrenheit. The fireplace was appropriately grated. Living room furniture was in good repair. Medications were locked near the dining room. 2 residents were observed eating lunch. LPA observed an adequate supply of perishable and non-perishable food in the kitchen. The stove hood was clean. Appliances were functional. Surfaces were sanitary. Sharps and cleaning solutions were locked above the counter top. Patio furniture was in good condition and shaded. The facility kept a pet dog outside. The laundry shed was behind the kitchen. It contained an operable washer and dryer, and detergents were locked in the shed. The facility had 4 bedrooms. 1 was private and 2 were shared. 1 bedroom was designated for staff. The staff bedroom was free of hazards and inaccessible. All bedrooms contained a chair, nightstand, nightlights, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Emergency exit paths were free from obstruction and unlocked. 3 out of 3 auditory alarms were on and functioning. The facility had 2 bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instruction sign, trash can with a tight fitting lid, grab bars near the toilet and shower, assistive devices, and a non-skid mat in the shower. At 11:56 a.m. LPA measured the water temperature in Bathroom #1 to be 116 degrees Fahrenheit. At 11:59 a.m. LPA observed a fully charged fire extinguisher in the kitchen It was purchased on 01/02/2022. At 12:06 p.m. LPA tested the dual function smoke and carbon monoxide detector to be operational. 2 out of 2 detectors functioned simultaneously, and an additional verbal alert sounded. During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued. Exit interview conducted. Copy of report provided.