Routine inspection·June 19, 2024

Licensing Program Analyst (LPA) Rankin made an unannounced 1-year required annual visit to the facility above. LPA met with Janet Johnson, House Manager, and Nikole Daugherty, Administrator, and explained the purpose of the visit. LPA requested a staff roster, a resident roster, emergency and disaster plan, and documentation of quarterly emergency drills. Documentation of quarterly emergency drills show they are done quarterly on various emergency events. LPA toured the facility with the Administrator and the following was noted: LPA observed the license posted, licensing reports, personal rights, non-discrimination notice, LTCO poster, CDSS Complaint Poster, Bill of Rights and Right to Residential Council . The facility has 10 bedrooms and 6 bathrooms, a kitchen, dining room, living room, courtyard in the front and back of the facility, and storage garage. Medications are kept in a locked room next to the kitchen. Physical plant was checked for cleanliness and condition. Walls, windows, ceilings, floors, floor coverings, and doors were checked, and all were in good condition. The facility maintains a comfortable temperature. The facility provides a working telephone for resident use. Smoke and carbon monoxide detectors are operational. Fire extinguishers (2) are located in the hall by room 1 and in the medication room and were last inspected 12/2023 and are charged in the green. There are no issues with Fire Clearance. LPA observed all chemicals are locked and inaccessible. The facility has cameras inside and outside throughout the facility, signed waivers were in all residents files reviewed. Continued on 809-C. Living and dining room furniture were also checked for functionality and condition. The living room and dining room are clean, safe and sanitary. Courtyard of the facility has outdoor furniture, with a covered shaded area for residents in the back yard. There are no bodies of water on the premises. There is plenty of outdoor lighting available for the safety of the residents. External gates have latches and working properly. Kitchen was sufficiently stocked with two-day perishable and seven-day non-perishables. The menu was posted for review. Snacks and beverages are available for residents in the facility when they want. Foods are properly wrapped and stored. Food storage and preparation areas are clean and inaccessible to pests. The refrigerator and freezer were in compliance with temperatures. Resident rooms have beds with sheets, pillowcase, mattress pad, and blankets which are in good condition. There is at least one chair, nightstand, and enough lighting for each resident. There is enough linen available to change weekly or more if need. Bathrooms were checked for cleanliness and proper operation. Residents have a sufficient number of supplies for personal hygiene. Soap, paper towels and toilet paper are provided by the Licensee. Grab bars are secured in toilet and shower areas. Showers have non-slip mats. Resident records were reviewed for requirements and legibility: LPA reviewed 4 residents’ files for current Medical Assessments with TB results, Current Appraisal Needs and Service plans, and signed Admission Agreements. Planned activities are offered to residents in care. Staff records were checked for expired or missing certificates and clearances: LPA conducted a file review of 4 staff for criminal record clearances/associations, Health screening with TB results, current First Aid/CPR, and annual training requirements. Continued on 9099-C Training is assigned by administrator via Relias to ensure annual requirements are completed and tracked. Medications are in a centrally stored and locked room next to the kitchen, including over-the-counter medicines. Medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the residents’ doctor. Proper medication dispensing instructions are followed. Exit interview conducted, and the report given.