Post-licensing visit·April 18, 2025

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced Post-Licensing visit. LPA was greeted by, identified herself to, and explained the purpose of the visit to Caregiver Kimberly Deahl. Administrator Sandy Wilson later joined the visit. The facility is licensed for a capacity of six, including five of which may be non-ambulatory of which one may be bedridden. Facility has a waiver granted for hospice care for four residents. LPA and Administrator toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order and bathroom sinks were compliant temperatures. The facility has enough linens, hygiene supplies, cooking and dining supplies, and perishable and non-perishable food for future resident use. All kitchen appliances were in working order. The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of sharp objects, medication, and confidential resident and staff records. (CONTINUED ON LIC 809-C, NEXT PAGE) (CONTINUED FROM LIC 809) The facility does have a pool with a fence. The fence was in good repair, at least 5 feet high, locked and of sufficient strength to withstand impact. The pool fence has a gate which self closes and is self-latching. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Per Administrator Sandy Wilson, no firearms or ammunition are or will be stored at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. All fire extinguisher(s) were serviced within the last twelve months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. No deficiencies were observed or cited during today's visit. An exit interview was conducted with Sandy Wilson, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.