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25 | At 10:30am on 11/14/2024, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to conduct the facility annual inspection. LPA met with Administrator, Jennifer Miller announced who he is and the reason for the visit.
Administrator and LPA conducted a full tour of the facility, and facility grounds. The facility is located in a rural area on approximately two acres which is gated. The facility has 6 bedroom, and 6 bathrooms, of which one bathroom is a common shared bathroom for residents, staff and visitors. There is a laundry room which has a refrigerator, a closed hallway that has a sink and locked cabinets where chemicals are stored. Medications are located in a locked cabinet in the hallway. The kitchen dining room and living room are open concept configuration. There are dual smoke detectors/carbon monoxide detectors throughout the facility and a individual carbon monoxide detector in the west hallway all currently functional. Administrator and LPA reviewed emergency disaster plan, infection control plan and fire clearance review. LPA reviewed staff, and resident files and reviewed medication records including Centrally Stored Medication Records (CSMR) LPA observed all resident bedrooms and bathrooms all found to be compliant with regulation standards. LPA observed full facility and facility grounds and found all to be compliant with regulation standards. LPA noted that there is a complete first aide kit on hand at the facility in the hallway closet. LPA noted that the facility food supply that currently meets or exceeded licensing standards of perishable and non-perishable foods. LPA noted that the facility is clean and in good repair. LPA noted that all exits and hallways were free and clear from obstructions.
Administrator and LPA conducted a full review of the care tools modules and discovered no issues, technical, violations, or citations.
Exit interview, report read, and report provided.
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