Routine inspection·September 17, 2025

Licensing Program Analyst (LPA) Rankin arrived at 8:49 am for the 1-year required annual visit. LPA met with Michael Easby Administrator. LPA conducted a review of the following and will return at a later date to complete the annual visit. Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 12/1/25. The facility is approved for a capacity of 330 residents. The fire clearance is granted for 330 non-ambulatory of which 20 may be bedridden. Resident Records & Incident Reports: The facility keeps separate files on each resident confidential. Facility does submit incident reports to the department when required. LPA reviewed 10 resident files for signed Admission Agreements, Personal Rights, Safeguard for property and valuables, Physicians report, Pre-appraisals, Appraisals Needs and Services Plan, and Emergency and ID forms. Disaster Preparedness: The current emergency disaster forms were reviewed. The facility last conducted a fire drill 8/21/2025. Annual fire inspection report was provided, City fire department inspected on 8/15/25, items addressed for updates were included in the report and has been completed or is scheduled Exit interview conducted and copy of report emailed for Administrator.