1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the purpose of the visit with Licensee Sheila Dillard. There are no residents living in the facility at this time
During this visit, LPA toured the facility inside & out. Resident bedrooms are found to be in good repair, contained required furnishings and lighting. The resident bathrooms were clean and in good repair with faucets delivering hot water at 115 degrees. LPA observed required hygiene items and grab bars. Towels, extra bedding, and linens were stored and available for use. The kitchen was clean, with necessary items and appliances. LPA observed required food supply and paper product storage. Knives/sharps, cleaning/disinfecting supplies and chemicals are locked and stored separate from food. Medications will be centrally stored in a locked closet. A First aid kits contained required items. There are visitation areas available inside and out. Doors and passageways are unobstructed throughout the facility. LPA observed a self-releasing gate and windows with screens in good repair. Smoke and Carbon Monoxide detectors were tested during the visit. The Fire extinguishers were purchased 9/1/23. Emergency Disaster Plan and Infection Control Plans were reviewed during this visit.
There were no citations during this inspection.
An exit interview was conducted and a copy of this report was provided to Sheila Dillard, whose signature confirms receipt.
LPA requested the following updated forms faxed to CCLD by 4/9/2024: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Affidavit Regarding Client/Resident Cash Resources (LIC 400), Emergency Disaster Plan (LIC610E) Proof of current Liability Coverage and Infection Control Plan. |