Routine inspection·September 13, 2022

Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted, granted entry into the facility by Staff and explained the reason for the visit. During the visit LPA toured the facility with Caregivers. Facility is a 6 bedroom,( 5 resident bedrooms 1 staff bedroom) and 3 bathrooms single story home. There are 3 Residents in care. LPA observed residents relaxing in bedrooms watching TV. LPA observed proper covid signage at front entrance of facility as well as a sign in, sanitization and temperature check station. Facility has required Department postings. LPA observed copy of Administrators Certificate expiring 04/26/23 LPA observed Emergency Disaster plan posted. LPA toured all Residents rooms, all rooms had required furnishings. All restrooms observed contained soap, toilet paper , sanitizer and towels. Restrooms had operating wash basin and toilet. Facility has operating audible alarms for each sliding door entrance/exit. Facility has operating smoke detectors and carbon monoxide detectors. Facility has 2 fire extinguishers which are fully charged. Facility has supply of PPE. Facility has 2 refrigerators and 1 freezer with ample food supply. LPA observed facility has emergency food and water supply. Facility has a secured location for resident medication and files. Facility has 30 days supply of medications for Residents. LPA reviewed Residents files during visit. LPA reviewed 3 out of 3 files. Residents emergency contact information and Physicians reports are current. Facility has secure location for Sharps and toxins. Facility has several designated visitation areas. No deficiencies noted during todays visit. An exit interview was conducted with Caregiver and a copy of report was left at facility.