KITCHEN: The LPA inspected the kitchen/food service area at 11:01 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates and food labels had expiration date clearly marked. The knives and sharps were observed in a locked drawer next to the refrigerator. Cleaning supplies and disinfectants are stored in a cabinet next to the dishwasher inaccessible to residents. At 11:04 a.m., the water temperature was tested in the kitchen faucet, and it measured 111.3 degrees Fahrenheit.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. At 11:11 a.m., smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed fully charged and last serviced on 3/26/2023.

(Report Continued on LIC 809C...)

BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. Emergency exits and passageways were observed free of obstruction. There is one gate that self-latches. No bodies of water noted at the time of the visit.

BEDROOMS: There are six (6) resident bedrooms. The LPA observed the resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There is a staff room on premises. The LPA observed a closet with extra towels and linens.

RESTROOMS: There are six (6) resident restrooms. Each bedroom has their own bathroom. Restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. The hot water temperature was measured in resident bathrooms and were compliant between 105- and 120-degrees Fahrenheit at the time of the visit.

RECORDS: Records review began at 11:20 a.m.; four (4) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All resident files were in order.

(Report Continued on LIC 809...)

The current Administrator’s file was also reviewed, and it was in order.

At the time of the visit, the LPA obtained the following documents: LIC500 Personnel Report, LIC9020 Client Roster, the emergency disaster plan, and a copy of the limited liability insurance.

The LPA conducted interviews with four staff members between 12:50 p.m. and 1:20 p.m.

MEDICATIONS: Medications review began at approximately 1:25 p.m.; medications are centrally stored and locked in a closet adjacent to the dining room. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review.

Exit interview conducted. No deficiencies issued. Report was reviewed and a copy was issued.