The facility was last visited on 06/30/2021 for an annual inspection. It is a single story building with 5 bedrooms, 4 bathrooms, kitchen, garage, pool, common areas, and outdoor areas. It has an approved fire clearance for 6 non-ambulatory residents, of which 1 may be bedridden. The facility serves residents with dementia. Approved hospice waivers for 6.

Entry: The front yard was maintained and free of debris. Hung on the front door was a sign regarding the facility’s visitation policy. Once inside, LPA observed postings for Ombudsman contact, confidential complaints, the most recent licensing report, COVID precautions, personal rights, and resident councils.

Screening: LPA was screened for symptoms of infectious disease upon entry. The screening station contained masks, sanitizer, a digital thermometer, and a visitor log. The visitor log tracked information for contact tracing, symptom screening, and temperature check. LPA recommended adding a column for vaccination records.

Bedrooms: The facility has 5 bedrooms. 1 bedroom is designated for staff. The staff room was locked. Of the 4 resident bedrooms, 2 are private and 2 are shared. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Beds in shared bedrooms were at least 6 feet apart for physical distancing.

Bathrooms: The facility has 4 bathrooms. A shared bathroom is located by Bedroom #1. Bedroom #3, Bedroom #4, and the staff room had private bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instruction signs, trash cans with tight fitting lids, and grab bars near the toilet and shower. At 3:06 p.m. LPA measured the water temperature in the shared bathroom to be 108.2 degrees Fahrenheit.

Common Areas: Walls, floors, ceilings, windows, screens, and curtains were clean and in good repair. LPA observed a storage closet by Bedroom #3 with an adequate supply of fresh linens. LPA also observed board games and reading materials near Bedroom #1. Cleaning solutions were locked in a storage closet by the living room. At 3:13 p.m. LPA measured the internal temperature to be 71 degrees Fahrenheit. 5 residents were observed watching television in the living room with staff. Seating was arranged to accommodate physical distancing.

Outdoor areas: LPA observed a covered patio area with furniture in good condition. LPA also observed a stationary bike, bicycle, scooter, and grill. A locked and an unlocked shed near the garage were used for storage. The pool had a secured perimeter with locked access gate. Access from the ramp by Bedroom #2 was locked.

Garage: A locked garage was located at the front. A functional washer and dryer were located inside. Detergent was locked.

Safety: All emergency exit paths were free from obstructions. The exit gate was unlocked with a self-closing latch. The Emergency Disaster Plan was posted at the front. Evacuation routes were illustrated and clearly labelled. Exits of Bedroom #2 and the living room had ramps. Ramps and handrails were secure and in good condition. The facility uses surveillance cameras inside. 4 out of 4 auditory alarm were on and functioning. At 2:59 p.m. LPA observed a fully charged fire extinguisher in the kitchen. It was last inspected on 05/21/2021. At 3:08 p.m. LPA tested a smoke detector to be operational. Smoke detectors were hard-wired and functioned together. The facility has a magnetic fire door at the front entrance. At 3:09 p.m. LPA tested the carbon monoxide detector to be operational.

During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued.

Exit interview conducted. Copy of report provided.