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25 | Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to and discussed the purpose of the visit with Safety Director Joey Gaal. The facility's license shows a maximum capacity of 332 ambulatory, 340 non-ambulatory residents, of which 12 may be bedridden. Hospice waiver for 6. During today’s inspection there were 557 residents in care. Executive Director Meegan Kline arrived during the visit.
LPA with Executive Director Kline and Safety Director Joey Gaal toured the interior and exterior of the facility, and inspected a sample of rooms. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. Per Safety Director Joey Gaal, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility.
LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas.
No deficiencies were cited during the inspection. An exit interview was conducted with Executive Director Kline to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
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