Routine inspection·May 7, 2024

Licensing Program Analyst (LPA), Stephanie Martinez, conducted an unannounced visit to the facility for a required annual inspection. The LPA was allowed entrance into the facility and met with Administrator, Garrett Welker. The LPA informed the Administrator of the purpose for the visit. The facility currently has an approved Hospice Waiver for six (6) residents. The inspection included the following: Physical Plant: The facility consists of six (6) resident bedrooms, one (1) staff room, a dinning area, an office, a living space, an open kitchen, a laundry room, and a patio with sufficient seating and space for activities. The LPA inspected the ground level of the home (staff rooms and independent living) and observed no concerns. There are no bodies of water located on the property. According to Administrator Welker, no weapons are stored in the home. The facility is being maintained at a comfortable temperature. All outdoor and indoor passageways are kept free of obstruction and are free of debris and other trash. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats or strips present. The carbon monoxide and smoke detectors were tested by the Administrator and were observed to be in operating condition. The home was kept clean and free of any odors. Food Service: There is a minimum of 2 days supply of perishable foods and 1 week's supply of non-perishable foods available. Sufficient supplies were available for resident's dinning use. Record Review: All staff were observed to have appropriate fingerprint clearances. LPA did not observe any excluded individuals on the premises at time of visit. Staff responsible for direct care and supervision have current first aid and CPR training. Training on Dementia Care, Postural Supports, Restricted Health Conditions, and Hospice Care was observed to be on file. The LPA was informed there is currently one (1) resident in care who is receiving hospice services. A hospice care plan was on file at the facility. There is a disaster and mass casualty plan in place. Emergency Drills are being completed. All services requiring specialized skill are being performed by a staff member of the facility, who is qualified as an appropriately skilled professional. The Physician's Report for Residential Care Facilities for the Elderly (RCFE) (LIC 602A) for Resident Four (R4) deemed the resident as bedridden. The facility does not currently have a fire clearance on file for a bedridden resident. A citation and civil penalty will be issued. Medication Review: The LPA reviewed medications for two residents. The medications were observed to be well organized and inaccessible to unauthorized individuals. An exit interview was conducted with Administrator Welker in which this report was reviewed and a copy was provided, in addition to the LIC 811, LIC 421IM, and instructions on appeal rights.