The facility has four (4) bedrooms and three (3) bathrooms designated for residents. Hospice waiver approved for 1 (1) resident. The facility serves residents with dementia. One resident uses an oxygen tank. Signage posted on the front door and throughout the facility.

At 10:15am, with the assistance of (S1) Administrator Elaine Bote, LPA conducted a physical plant to ensure facility is in compliance with Title 22 Regulations. Facility Temp measured at 76 degrees.

Required postings were observed in the entry area. The smoke alarms are hardwired and interconnected. 3 out of 3 auditory alarms were on and functioning during today’s visit. The carbon monoxide and smoke detectors were tested and function properly. One (1) fire extinguisher was observed in the kitchen. The charge date is 12/27/23.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility located in a brown industrial sized cabinet.; properly stored. Knives were stored and locked under the sink the kitchen. Properly labeled medications were locked and secured in a grey industrial cabinet near the kitchen the Administrator office along with resident files. All household cleaning products were locked in the laundry area.

Bedrooms: There were five (4) bedrooms designated for residents' use. Two (2) rooms will be shared, and one (1) room were private at the time of the visit. LPA observed rooms to have bedding sheets, pillowcase, blankets, mattress pads, which are in good condition. There is at least one chair, a night stand, and sufficient lighting for each client.

The mattresses and bedsprings were also checked for condition. Window covering and window screens are in good repair for each room.

Bathrooms: There are three (3) bathrooms designated for residents' use. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 113 degrees Fahrenheit. Cleaning supplies are being stored.

Laundry area was observed to be locked. Both appliances were in good working order. Detergents and solutions were locked and secured inaccessible to residents.

Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. LPA observed surveillance cameras in common areas.

Outside grounds were toured and no bodies of water were observed. Facility has two (2) sheds in the backyard. The grey shed was located in the east corner of the facility stored extra supplies. The second shed located in west corner stored garden supplies. Both had padlocks and secured. Facility also has a basketball court and workout equipment for residents and staff. Patio furniture under a shaded area was accessible to clients. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises.

At 11:02 AM LPA conducted a file review.

7 staff records were reviewed, 7 out of 7 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions.

5 resident records were reviewed and, 5 out of 5 client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans.

Medication and Medication Records were reviewed for proper documentation.

No deficiencies cited.

An exit interview was conducted, A copy of this report and appeal rights were discussed and left with Administrator Elaine Bote.