Routine inspection·March 14, 2024

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the two caregivers. LPA stated the purpose of the visit was to conduct an annual inspection. The Administrator arrived at 10:55 am. The staff confirmed there are three residents. The facility is licensed for six (6) non-ambulatory, bedridden residents. LPA Spaeth and the caregiver toured the facility at 10:10 am until 11:19 am. Common Areas – The living room and family room contained comfortable seating. A dining room table with chairs are located in the kitchen. The family room contained a television. Kitchen - LPA Spaeth observed a two day supply of perishable food and a seven day supply of non-perishable foods. The knives and cleaning solutions were securely locked underneath the kitchen sink. The fire extinguisher is located in the kitchen and is operable. Medication - LPA observed the resident medications, first aid kit, and PPE supplies were safely locked in a kitchen cabinet.. Garage//Washer & Dryer – The laundry room was locked and contained the washer/dryer. The door leading to the garage was locked. The garage contained the laundry detergent and an additional refrigerator. Continued on 809-C Resident Rooms: The resident rooms 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. The water temperature was recorded to be 134.0 Degrees F. 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 11:15 am and were operable. LPA Spaeth reviewed the resident and staff files at 11:40 am until 12:30 pm. LPA reviewed the medications at 1:00 pm. Based upon Title 22 Regulations, the following deficiency is substantiated. (See 809-D page). Exit interview conducted, appeal rights discussed, and a copy of the signed report was given