Routine inspection·November 6, 2024

Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Administrator, Kelly Evans and introduced self and stated purpose of the visit. LPA was informed that there is 1 resident in care. The facility has 4 bedrooms, 2 bathrooms, kitchen, 2 dining areas, living room, family room, office, laundry, backyard, and attached garage. LPA completed a walk through of facility and review of records with Administrator, Kelly Evans. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 72 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 108.2 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, charged fire extinguisher and first aid kit. Posters such as; the personal rights, emergency disaster plan, and ombudsman were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept locked and inaccessible to residents. There was a designated storage space for resident/staff files. Medications was observed locked and inaccessible to residents. There is no swimming pool, bodies of water, firearms or ammunition in the facility. LPA observed that the facility's living room, kitchen and dining areas were not clean. Deficiency issued. Food Service : Non-perishable and perishable food supply is sufficient for residents in care. Dishes, cups, and utensils were also stored properly. Yards/Outside: One shaded patio, side gate with self-latching handle on the left and right side of the house that leads into the backyard. Record Review: LPA reviewed staff and administrator file for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA observed that the administrator's file was not available for audit. Deficiency issued. LPA observed that the facility did not renew the Administrator Certificate Requirements. Deficiency issued. LPA reviewed resident file for admission agreements, updated physician reports, and needs and services plans. LPA observed through record review and interview that the facility did not have a liability insurance. Deficiency issued. LPA observed that the facility did not have a record of disaster drills conducted quarterly. Deficiency issued. LPA observed that the facility has not reviewed/updated the emergency disaster plan annually. Deficiency issued. Deficiencies were cited during this visit. An exit interview was conducted where this report LIC809, LIC809C, LIC809D,and appeal rights were discussed and copies were provided to Administrator, Kelly Evans.