Routine inspection·January 31, 2025

On January 31, 2025 Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by Administrator Marifel Ivers and granted entry after stating the purpose of the visit. Administrator (Admin) Marifel Ivers assisted with the facility inspection on today's date. The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for four (4) residents. Currently, there are two (2) Hospice residents present during today’s visit. This is a single story home with a detached garage facility. The facility has four bedrooms (three shared resident rooms and one staff room) and two full bathrooms. At around 7:31 AM, LPA conducted a tour of the physical plant accompanied by Administrator Ivers, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 118.6 degrees F. A comfortable temperature of 71 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, appliances were operational and sufficient perishable and non-perishable food was maintained adequately. Facility has pantry, two fridges and two freezers. Facility has emergency food and water supply. Facility has two fire extinguishers fully charged and mounted on walls. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. CONTINUED ON 809C During the visit, LPA observed the facility's infection control practices. LPA observed sanitizing stations in common areas and restrooms. LPA observed the facility has supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The last fire drill was conducted on January 7, 2025. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective 4/8/2024 - 4/8/2025. A review of six residents (R1-R6) service files and two staff (S1-S2) personnel files revealed to be complete. The facility has the current administrator's certification active on certificates list on file for Marifel Ivers # 7033541740 application received 11/7/2024. No deficiencies during this inspection visit. An exit interview was conducted with Administrator Marifel Ivers, and a copy of the report was provided.