Routine inspection·March 2, 2023

On March 02, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived to the above listed facility unannounced in order to conduct the required annual inspection. LPA Mixson met with Executive Director, Shannon Moore, introduced self, stated the purpose of the visit, and toured the facility inside and out. The facility is a locked perimeter memory care unit. Currently there are 36 Residents 37 Staff and/or caregivers. The facility has two separate buildings that consist of 28 total rooms (14 shared rooms in each building). There a single large kitchen, a smaller kitchen, two dining areas, and several common/living areas. Physical Plant: The physical plant, in general, was in good repair. The facility is operating in the capacity approved by Community Care Licensing (CCL). The buildings and grounds were free from hazards. Outdoor and indoor passageways were kept free of obstruction. LPA Mixson inspected a sample of resident bedrooms and bathrooms. Resident bedrooms have the required bedding and furniture; such as clean mattresses, night stands, storage space, and sufficient lighting. Room temperatures were comfortable for residents in care. LPA Mixson inspected a sample of resident bathrooms; the bathroom appliances were operating in safe and sanitary conditions. LPA Mixson tested the hot water temperature in a few restrooms, in which the bathroom sink faucets tested within the required regulation. The restrooms were equipped with non-skid surfaces and grab bars. All resident bedrooms and bathrooms were equipped with signal systems. LPA Mixson toured the kitchen and dining area. The facility was stocked with the required two day supply of perishables and seven day supply of non-perishable food items that were labeled. The facility had a menu posted and available for review it was up-to-date. Kitchenware was in good condition and stored safely. Emergency food and water were also observed. LPA Mixson inspected the common areas. Smoke detectors were last tested on 12/ 13/2022 by JJJ Enterprises. Carbon monoxide alarms were observed. There was a locked and centralized storage area for medications. Medications are order through a pharmacy that utilizes bubble packs. The facility had a designated area for resident files and staff files. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There was adequate seating in the common areas and sufficient space for activities. LPA Mixson observed an activity calendar. LPA Mixson reviewed six staff files and five resident files, and interviewed two staff and spoke with one resident. There were no regulation violations observed at this time. An exit interview was conducted and a copy of this report, along with the LIC 811 was provided to Director.