Routine inspection·March 18, 2022

Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced annual required visit. LPA met with the administrator and explained the reason for this visit. A tour of the physical plant was conducted. The facility has applied for a license to service elderly residents. The facility has a fire clearance for six non-ambulatory residents, one of which may be bedridden in room 1 or 2. The facility has four resident bedrooms two of which are intended for double occupancy (rooms 4 & 5). All resident rooms designated for resident use have direct exits to the outside. There are six residents in the facility, all resident rooms have appropriate lighting, furniture, bedding, and linens. There is one room designated as a staff room. At the time of the visit, all exit doors had functional auditory alarms. There are two bathrooms designated for resident use. Room 5 has an attached bathroom. The other rooms share a bathroom located in the hall. There were appropriate grab bars for both showers. There are non-skid mats in both showers. The common areas were appropriately furnished and lighting was adequate. Resident and staff records are stored in a locked cabinet in the kitchen. Medications are stored in a locked cabinet in the kitchen. The first aid supplies are stored in the same cabinet as the medications. First aid kit is compliant with regulations at the time of the visit. Kitchen knives are stored in a secured cabinet in the kitchen. Stove burners are functional. The supply of perishable and nonperishable food is adequate. The supply of dining and cook ware is adequate. Appliances in the kitchen were clean and functional. Kitchen and house cleaning supplies are stored in a locked cabinet under the kitchen sink and the garage. Laundry supplies are stored in a locked cabinet above the washer. The facility smoke alarm system is hard wired and functional. There is one fire extinguisher in the kitchen area. The fire extinguisher is fully charged. There is a functional carbon monoxide detector in the hallway. Hot water was tested; it measured at 117 degrees Fahrenheit. The laundry area is located just outside the kitchen in the hall. The supply of extra bed and bath linens is adequate. Personal hygiene items will be provided for residents. Extra incontinency supplies are stored in the hall. Telephone service for the facility is functional. Emergency exiting sketch is posted on the wall in the entry area. Required postings are posted in the dining area. No deficiencies cited during this visit. Exit Interview conducted.