The facility is a single story building with six (06) bedrooms, two (02) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (06) residents, of which five (05) may be nonambulatory and one (01) bedridden in Bedroom #5. The facility serves residents with dementia.

LPA observed a maintained front yard. The walkway leading to the main entrance was free of debris. Gardened areas contained fruit-bearing trees in the front and back yards. Postings located at the front and side living room included the administrator’s certificate, personal rights, rights of resident councils, emergency disaster plan, facility sketch with evacuation routes clearly labeled, confidential complaint poster, Ombudsman contact poster, house rules, facility license, emergency contacts, an emergency disaster plan.

Walls, floors, windows, screens, and blinds were clean and in good repair. At 1:50 p.m. LPA measured the room temperature to be 71.0 degrees Fahrenheit. The hallway contained functioning night lights and a closet for hygiene supplies. Fully charged fire extinguishers were observed near the kitchen and side living room. Two (02) residents were observed watching television in the main living room which also contained games and reading materials. The side living room contained emergency water, confidential files, locked medications, and exercise equipment.

The facility has six (06) bedrooms. One (01) bedroom is designated as a staff room. The staff room was unlocked and free of hazards. The five (05) resident bedrooms contained a chair, lamp, nightstand, dresser, storage, and a bed with adequate bedding. All furnishings were clean and in good condition.

LPA observed an adequate supply of perishable and non-perishable foods stored in the refrigerator, freezer, and pantry. The stove and surfaces were clean. Appliances were in good condition. Sharps were locked below the countertop. Cleaning solutions were locked below the sink.

A washing machine and dryer were located in the garage. Both were in working order. Detergents were locked in a storage shed. The garage stored additional supplies.

LPA observed a covered patio area in the rear of the facility. The patio contained shaded furniture in good condition. A storage shed contained additional supplies. The emergency exit path was free of debris. The exit gate was unlocked. Three (03) out of three (03) auditory alarms were turned on and functioning.

LPA reviewed personnel and resident files at 2:15 p.m. All files were up to date and available for audit.

At 3:00 p.m. the house phone was called and confirmed to be functional. At approximately 3:05 a.m., smoke and carbon monoxide detectors were tested and operational.

During today's inspection, the facility was in compliance with Title 22 regulations. No immediate health or safety hazards were noted during the time of this visit.

Exit interview conducted. Copy of report provided.