Routine inspection·January 31, 2023

At 9:40 a.m. on 01/31/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with the Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out. The facility was last visited on 11/01/2022 for a complaint visit. It is a single story building with 4 bedrooms, 2 bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for 6 nonambulatory residents, of which may be bedridden. Approved hospice waivers for 2 residents. At the main entrance, LPA observed a maintained front yard and a covered patio area with seating in good condition. The screening station contained a visitors’ log, digital thermometer, N95 masks, and surgical masks. Postings included confidential complaint contacts, Ombudsman contacts, personal rights, facility sketch, and facility license. Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. At 9:52 a.m. LPA measured the room temperature to be 70 degrees Fahrenheit. At 9:55 a.m. LPA observed a fully charged fire extinguisher in the kitchen. LPA observed an adequate supply of perishable and non-perishable food. The stove hood was clean and appliances were functional. Sharps were locked below the counter top. The counter top had a crack in it. The Administrator stated the crack is scheduled to be repaired. Cleaning solutions and detergents were locked below the sink. Medications were locked near the kitchen. A laundry area near a side exit contained a washer and dryer in working condition. The facility had 4 bedrooms. Bedroom #1 was vacant and private. Bedroom #2 and Bedroom #3 were shared bedrooms. Bedroom #2 had a resident with full bed rails who was on hospice. Bedroom #4 was a private room. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition. The facility had 2 bathrooms. All bathrooms contained liquid soap, handwashing instruction signs, grab bars in the shower, and a non-skid mat in the shower. At 10:06 a.m. LPA measured the water temperature in the women’s bathroom to be 112.8 degrees Fahrenheit. LPA observed a resident smoking in the back yard patio. The area was shaded and contained seating in good repair. All emergency exit paths were free from obstructions. At 10:11 a.m, LPA tested the dual-functioning smoke and carbon monoxide detector in the hallway to be operational. During today's inspection, the facility is in compliance with Title 22 regulations. Exit interview conducted. Copy of report provided.