The facility was last visited on 04/21/2022 for an annual inspection. It is a single story building with five (05) bedrooms, two (02) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents, of which one (01) may be bedridden in Bedroom #5. The facility serves residents with dementia. Approved hospice waivers for six (06).

LPA observed an adequate supply of perishable and non-perishable foods in the kitchen. The stove hood was clean. Appliances were in good condition. Sharps were locked below the sink. Cleaning solutions and detergents were locked above the washer and dryer. Medications were locked in a cabinet in the kitchen. A washing machine and dryer were located adjacent to the kitchen. Both were in working order. At approximately 1:40 p.m. LPA observed a fully charged fire extinguisher in the kitchen. It was last inspected on 05/03/24.

At the main entrance, LPA observed postings for confidential complaint contacts, ombudsman contacts, emergency contacts, facility license and sketch, personal rights, emergency disaster plan, and visitation policy. A visitor log recorded guests and screened for infectious disease.

Walls, floors, windows, screens, and blinds were clean and in good repair. An activity calendar was posted near the kitchen. Around 1:50 pm. the administrator informed the LPA that an Activity Director manages and schedules activities, and a physical activity assistant comes to the facility twice per week to assist with resident fitness. At approximately 2:00 p.m. smoke and carbon monoxide detectors were tested and operational. At 2:05 p.m. LPA measured the room temperature to be 77 degrees Fahrenheit. The living room contained television, seating, decorations, and a piano.

LPA observed a covered patio area in the rear of the facility. The patio contained furniture in good condition and exercise equipment. An additional couch was located under a covered awning. A storage shed was locked.

The facility has five (05) bedrooms. Bedroom #3 is designated as a staff room. The staff room was unlocked and free of hazards. Bedroom #1 and bedroom #2 are shared rooms. Bedroom #4 and Bedroom #5 are private rooms. All bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition. All bedrooms had immediate exits to the outside which were unlocked. Ramps leading out from bedroom #2 and bedroom #5 were free of tripping hazards and had sturdy handrails.

The facility has 2 bathrooms. 1 bathroom is private, and 1 is shared. All bathrooms contained liquid soap, paper towels, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid surface in the shower. At approximately 2:30 p.m. LPA measured the water temperature to be 107.7 degrees Fahrenheit.

All emergency exit paths were free from obstructions. Exit gates were unlocked with self-closing latches. Evacuation routes were posted. All auditory alarms were turned on and functioning.

At 2:30 p.m. LPA reviewed resident and personnel files. At 3:15 p.m. LPA conducted staff and resident interviews.

During today's inspection, the facility was in compliance with Title 22 regulations. No immediate health and safety risks were observed.

Exit interview conducted. Copy of report provided.