The facility was last visited on 11/06/2023 for an annual inspection. It is a single story building with six (06) bedrooms, two (02) bathrooms, kitchen, laundry room, garage, common areas, and outdoor areas. It has an approved fire clearance for six (06) residents, of which five (05) may be non-ambulatory and one (01) bedridden in Bedroom #5. The facility serves residents with dementia. Approved hospice waivers for six (06).

At 10:15 a.m. today, LPA obtained documents including but not limited to the staff roster, resident roster, staff files, and resident files for review.

At approximately 11:30 a.m. LPA observed a fully charged fire extinguisher in the laundry area. It was last inspected on 03/28/24. All emergency exit paths were free from obstructions. The exit gate was unlocked with a self-closing latch. At approximately 11:45 a.m. the dual-purpose smoke and carbon monoxide detector was tested and operational. Facility detectors are hard-wired and functioned simultaneously during the test. The fire door near the main entrance closed during the test as well. Between 11:30 a.m. and 12:00 p.m. three (03) out of three (03) auditory alarms were tested to be on and functioning.

At the main entrance, LPA observed a visitor log as well as postings including but not limited to the facility’s visitation policy, non-discrimination notice, a blank copy of the admission agreement, resident rights, rights of resident councils, facility sketch with evacuation routes clearly labeled, and contacts for the Ombudsman and confidential complaints.

The facility has six (06) bedrooms. Two (02) bedrooms are designated as staff rooms. The staff rooms were locked and free of hazards. All bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition.

Walls, floors, windows, screens, and blinds were clean and in good repair. The living room contained furniture in good repair, an appropriately covered fireplace, and a piano. At 12:30 p.m. LPA measured the room temperature to be 79 degrees Fahrenheit.

LPA observed an adequate supply of perishable and non-perishable foods in the kitchen and garage refrigerators, freezers, and pantries. The garage was locked. The stove hood and surface were clean. Appliances were in good condition. Sharps were locked under a counter. Cleaning solutions were locked in the laundry area. Medications were locked as well.

A washing machine and dryer were located near the kitchen. Both were in working order. Detergents were locked above the appliances.

LPA observed a covered patio area on the side of the facility. The patio contained furniture in good condition. The ramp which led to the emergency exit was in good repair with a sturdy handrail.

During today's inspection, the facility was in compliance with Title 22 regulations.

Exit interview conducted. Copy of report provided.