Routine inspection·September 6, 2022

Licensing Program Analyst (LPA) Kruz Long conducted a site visit for the annual inspection. Upon arriving at the facility LPA met with Alan Robert Buan (Administrator) and explained the purpose of the visit. The facility is licensed to serve: AGE RANGE 60 AND OVER. 6 AMBULATORY, OF WHICH 6 MAY BE NON-AMBULATORY. HOSPICE WAIVER FOR 3. The facility is located in a residential area. A tour of the single-story facility includes: Living room, kitchen dining area, attached garage/storage/laundry, 4 resident bedrooms, 1 staff bedroom, and 2 bathrooms. During today's visit, LPA observed the following: The facility maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. Facility is not operating over-capacity or beyond any conditions and limitation on the license. No pools and bodies of water on the premises. Facility maintains a comfortable temperature for residents. All outdoor and indoor passageways is kept free of obstruction. Hot water temperature measured at 113.7 degrees F in bathroom #1. There is a presence of grab bars for each toilet, bathtub and shower used by residents. Bathtub or shower have non-skid mats or strips. The total daily diet is of the quality and in the quantity necessary to meet the resident’s needs. Minimum of one week supply of nonperishable foods and 2 days of perishable foods was observed. All readily perishable foods or beverages capable of growth of micro-organisms is stored in covered containers at appropriate temperature. The facility ensures sufficient and competent staff to provide the services needed to meet resident needs. Staff assisting residents with ADLs received required training. Criminal Record Clearance for all required persons is associated to the license. Staff responsible for direct care and supervision have current first aid training. Licensee has obtained and kept on file documentation of a medical assessment, signed by a physician. Facility have a disaster and mass casualty plan. Employees of CCLD is allowed to enter the facility to conduct inspections. A certified administrator is on the premise for a sufficient number of hours to manage and oversee the business operation. Medications is given per the physician’s directions. There is a signed and dated written order from a physician for every prescription and nonprescription PRN medication. Centrally stored medicines is kept in a safe and locked place. No deficiencies were observed during today's visit. An exit interview was conducted and a copy of this report was provided to Alan Robert Buan.