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25 | At approximately 9:40 a.m. on 04/23/26, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with staff and disclosed the reason for the visit.
The facility was last visited on 04/02/25 for an annual inspection. It is a single story building with four (04) bedrooms, two (02) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents, of which 1 may be bedridden in Bedroom #2. The facility serves residents with dementia. Approved hospice waivers for three (03).
At 9:50 a.m. LPA reviewed resident and personnel files. All files were complete and available for audit.
LPA observed a maintained front yard and postings at the main entrance for the facility’s COVID and visitation policy. Inside the main entrance, LPA observed postings for emergency contacts, confidential complaint contacts, Ombudsman contacts, personal rights, theft and loss policy, administrator certificate, facility sketch with evacuation routes posted, a blank copy of the admission agreement, and COVID postings. LPAs observed a screening station with digital thermometer, visitor log, sanitizer, masks, and additional PPE.
Walls, floors, windows, screens, and blinds were clean and in good repair. At 10:00 a.m. LPA measured the room temperature to be 73 degrees Fahrenheit. Three (03) residents were engaged in activities at the dining table and one (01) was watching television. The living room contained karaoke, a television, reading materials, puzzles, and furniture in good condition. A fireplace was appropriately covered and turned off. A locked cabinet near the television contained confidential files. A closet in the hallway contained a sufficient supply of fresh linens and incontinence supplies.
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