Routine inspection·January 8, 2025

On 1/8/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Executive Director, Peter Nixdorff. The facility currently provides care for 62 residents, 4 of which are receiving hospice services, along with a designated memory care unit. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located on each resident floor and kitchen were found to be last charged. Carbon monoxide detectors were located at each hallway tested and functioning. Smoke and sprinkler systems are interconnected with a fire safety inspection conducted by separate outside agency. Water at faucets accessible to residents were measured and found to be within regulation. All resident restrooms are equipped with non-slip mats and grab bars for accessibility. During the inspection, LPA observed oxygen tank in resident bedroom without appropriate signage posted. Executive Director immediately contacted staff to place sign indicating oxygen in use. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen, sufficient for residents in care. Food supply is replenished three times per week and stored properly. Facility provides a wide variety of meal preferences and preparation while also ensuring proper dietary restrictions are followed. Cleaning supplies and other toxins are safely stored in locked closets throughout each floor, and housekeeping/maintenance rooms all of which were secured upon inspection. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. During inspection of resident bedroom, LPA located a tool bag left by residents family that held items potentially dangerous to residents in care. Executive Director immediately contacted resident's family member notifying of the concern and placed the tool bag in a secured staff office. Executive Director agrees to further discuss with resident family on safety risks. Technical Violation issued. Continued onto LIC809-C Residents that were awake during the inspection were observed interacting with staff, fellow residents and visitors in the common areas, or in their bedrooms resting. The facility encourages regular family visits and utilizes a wide variety of activities with LPA observing staff engaging continuously with residents, offering activities based on individualized preferences. LPA found that staff and resident engagement is well practiced with activities observed throughout the day. Residents were observed to have a positive and personable relationship with staff and Executive Director and were often out in the community during the inspection. There is a large outdoor patio for resident use, equipped with appropriate shading. A spot check of medications was conducted and found that all medication counts and records are in order. Medtech staff were knowledgeable of all medication administration and destruction procedures. LPA conducted a sample file review for residents and found all items to be in order including medical assessments and needs & service plans. Upon a spot check of staff files, LPA found that caregiver staff have current 1st aid and CPR on file. Peter Nixdorff's Administrator Certificate 7014086740 is currently active through 1/26/2025 . LPA requested the following documents be sent to CCL by COB 1/22/2024: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Liability Insurance