Pre-licensing visit·December 12, 2023

On 12/12/23 Licensing Program Analysts (LPAs) Maja Jensen and Kesha Lewis arrived at facility unannounced to conduct a pre-licensing visit for a change in ownership. LPAs Jensen and Lewis met with Executive Director Aimee Jo Mattson and explained the purpose of today's visit. LPA Jensen toured the facility including grounds, physical plant. The grounds were observed to be maintained and all paths were clear of debris. LPA Jensen toured 5 resident rooms and observed all to be equipped with the required furniture including chairs, lamps, and night stand. The water temperature in resident bathrooms and kitchenette was measured at 118 degrees which is in compliance. Unsecured cleaning chemicals were observed in resident room cabinets in the assisted living portion of the facility which included Lysol cleaner, Spray and Wash and Liquid Gold wood cleaner. The laundry room was found to be unlocked. LPA Jensen reviewed the disaster plan and confirmed it to be in compliance. The facility has hard wired smoke detectors and a sprinkler system. The carbon monoxide detector was tested and determined to be in good working order. The fire extinguisher was last serviced in March of 2023 and is in compliance. One end of the building is equipped with a back up generator. The entire building has emergency lighting throughout the common areas. The first aid kit was observed to be complete. All required postings were observed to be displayed in a prominent location. The Pre-Licensing tool was used during the course of this inspection. LPA Jensen toured the kitchen. The facility maintains a 7 day supply of non-perishable food and a 2 day supply perishable food. All food was labeled and no expired food was observed. The kitchen was observed to sanitary. The kitchen chemicals were in a separate locked storage room. The freezer and refrigerator temperature was in compliance. Kitchen staff are appropriately trained and certified. Continued on LIC 809C... LPA Jensen inspected the medication room. LPA Jensen asked the medication technician to open the locked medication cart. Syringes were observed in the medication cart. LPA Jensen asked the medication technician if any residents are insulin dependent residents and was advised that there are. LPA Jensen asked who administers the insulin and was advised by the medication technician that residents administer their own insulin with hand over hand assistance by staff. LPA reviewed the LIC 602 for Resident 2 (R2) which states the resident is unable to administer their own medication or injections and cannot conduct their own glucose testing. The facility has not passed the pre-licensing inspection and has been asked to submit a diabetic care plan and to remove all chemicals from resident rooms. The Executive Director anticipates having completed the requested items no later than 12/22/23. An exit interview was conducted and a copy of this report, appeal rights and an LIC 811 was provided.