Routine inspection·March 4, 2026

Licensing Program Analyst (LPA) Melisa Rankin arrived at 9:22 a.m. to conduct a required 1-year annual visit. LPA met with Jessica Rust, Administrator. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Physical Plant & Environment Safety: LPA toured resident rooms and observed that rooms were tidy and free of odor. The lighting and lamps are sufficient for the use of the facility and for resident comfort and safety. Toilet, hand washing and bathing facilities are operational and secure grab bars are present. The showers have slip resistant mats and/or flooring. The pathways are clear of any obstructions, there are raised concrete in the patio area that are scheduled to be leveled down. Disinfectants and cleaning solutions are inaccessible to residents in care and locked in closet. The facility has sufficient space inside and outside for activities and visiting. The facility has a fenced backyard for client use with plenty of shade. The fire extinguisher was last charged and inspected on 12/8/25. The facility has smoke and carbon monoxide detectors that were tested and working properly. Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with resident rooms regarding the granted fire clearance. The facility is approved for a capacity of 6. The fire clearance is granted for 5 non-ambulatory residents and 1 bedridden resident. The facility currently has 3 residents. Staffing, Personnel Records & Training: The facility currently employs 4 staff and has 2 administrators who also provide caregiving coverage. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance/Associations/exemptions. Administrator Certificate expires on 10/05/26. Staff have annual training completed for various subjects/topics and hours for 2025. Medication training was completed. Continue on 809-C Resident Records & Incident Reports: The facility keeps separate files on each resident confidentially. Facility does submit incident reports to the department when required. LPA reviewed 3 resident files for signed Admission Agreements, Personal Rights, Safeguard for property and valuables, Physicians report, Pre-appraisals, Appraisals Needs and Services Plan, Emergency and ID forms. All forms were legible, all records complete. Food Service: The facility has 2-day perishables and 7 day non-perishables to meet the food service requirement. All food is covered, stored, and marked appropriately. The kitchen is clean and sanitary. Cleaning solutions and equipment are stored separately from food supplies. Incidental Medical Services: Facility provides transportation or assists in providing transportation to medical and dental appointments when needed. The facility uses the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed 3 residents’ medications, no labels were altered, and no medications were expired. Residents with recent changes are being reviewed and will be communicated to LPA for clarification. Disaster Preparedness: The current emergency disaster forms were posted. The facility conducted a quarterly disaster drills. Emergency exits and telephone numbers were posted. A set of keys is available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care. The facility has 2 self-latch gate on side of the home. The facility does not have delayed egress, locked doors or gates. Exit interview conducted and copy of report printed for Administrator.