Routine inspection·February 13, 2025

On 2/13/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA met with Administrator Garrett Welker and explained the purpose of the visit. At the time of the visit there was (3) staff and (4) residents present. The facility has an approved hospice waiver for (2) with a total of (1) resident receiving hospice services. The facility was observed to be clean and clutter free. There was an ample supply of personal hygiene and cleaning supplies that were locked and inaccessible to residents in care. In addition the facility does not utilize a MAR system, but does keep track using a centrally store record. Medications were present and accounted for. The licensing fees were paid during today's visit, and the facility is in possession of valid liability insurance as well as governing body is in good standing. The facility is conducting emergency disaster drills every other month and the last drill was conducted on 02/05/25. The facility has fully charged fire extinguishers. The hot water was tested and was within regulatory limits, measuring between 109.3-110.4 degrees Fahrenheit. The facility food supply was adequate, with a 2 day supply of perishable, and a 7 day supply of nonperishable food items. The resident and staff files had the required forms. All staff present were observed to have obtained criminal record clearance, and to be associated to the facility. The facility Administrator was observed to have renewed their certification that is currently pending, with a certificate expiration date of 02/08/27. The smoke and carbon monoxide detectors were tested and observed to be operable. There were no citations issued during today's inspection. An exit interview was conducted and a copy of this report was provided to Garrett Welker, Administrator.