Routine inspection·December 1, 2022

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA met with administrator and explained the purpose of the visit. Administrator certificate #6043428740 expires on 01/25/2023. This facility is a single story building licensed to serve six (6) non-ambulatory residents and has a hospice waiver for 2 residents. LPA and staff toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present. Liability Insurance expires 4/26/2023. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 116.0 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 7/7/2022. Thermostat observed at 75 degrees Fahrenheit. LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to residents. LPA reviewed two (2) resident files and three (3) staff files. A review of staff records indicates that all facility staff & other individuals who require caregiver background checks are fingerprint cleared and to the facility. LPA verified staff training for staff file reviews and all 3 staff have current First Aid Certificates. No deficiencies were found during today's visit. Exit interview held with administrator and a copy of report given at the conclusion of the visit.