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) Celine De Perio conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA De Perio explained reason for visit and was greeted and granted entry by staff on duty who checked temperature prior to entering facility. During the visit, 4 staff were on duty, including facility administrator (AD) Alan Shelley and house manager (HM) Madison Shelley. As of 10/20/22, there are 0 active COVID-19 cases in the facility as verified. LPA De Perio observed the COVID-19 precautionary signs posted at the entrance of the facility. The PUB475 "See Something, Say Something" poster was also observed in the facility hallway. LPA observed the Administrator's Certificate for Alan Shelley, which expires on 3/24/23.
LPA De Perio toured the interior and exterior portions of the facility with HM Shelley. The facility is a single level structure and is licensed for 6 non-ambulatory residents of which 0 may be bedridden and there is a hospice waiver for 4. For this visit, there are a total of 5 residents in care, of which 4 are on hospice. There are a total of 6 bedrooms, of which all are private rooms for residents. There is a pull-out bed located in the hallway and is for staff use. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 3 restrooms, of which were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 113.2 degrees Fahrenheit and hand washing signs were also posted in each restroom.
Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located under the medication cabinet.
|