Land of Peace 1.

At approximately 8:50 a.m. on 07/24/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the administrator and disclosed the reason for the visit. The facility was last visited on 07/09/2024 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 the main entrance and near the kitchen, LPA observed a visitor log as well as postings including but not limited to the facility’s visitation policy, a blank copy of the admission agreement, resident rights, rights of resident councils, facility sketch with evacuation routes clearly labeled, emergency disaster plan, house rules, and contacts for the Ombudsman and confidential complaints. The facility had six (06) bedrooms. Two (02) bedrooms were 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. Five (05) out of six (06) hospital beds had wheels in the locked position. One (01) hospital bed had inoperable brakes, and the administrator ordered a new bed during the visit. The facility had two (02) bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instructions sign, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid mat in the shower. At 9:15 a.m. LPA measured the water temperature in Bathroom #1 to be 119.3 degrees Fahrenheit. 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 26 27 28 29 30 31 32 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. LPA observed four (04) residents watching television together. Reading materials, art supplies, and exercise equipment. At 9:20 a.m. LPA measured the room temperature to be 73 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 and inaccessible. 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 above the counter. At approximately 9:30 a.m., staff and LPA conducted a medication review for three (03) residents. All resident medications were stored and accounted for in the correct quantities. A washing machine and dryer were located near the kitchen. Both were in working order. Detergents were locked above the appliances. At approximately 10:30 a.m. LPA observed a fully charged fire extinguisher in the laundry area. All emergency exit paths were free from obstructions. The exit gate was unlocked with a self-closing latch. At approximately 11:00 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 11:10 a.m. and 11:30 a.m. four (04) out of four (04) auditory alarms were tested to be on and functioning. The house telephone was called at 11:35 a.m. and deemed operational. LPA observed three (03) covered patio areas on the side and rear of the facility. The patios contained furniture in good condition. The ramp which led to the emergency exit was in good repair with a sturdy handrail. LPA reviewed resident and personnel files. All files were complete and available for audit. During today's inspection, the facility was in compliance with Title 22 regulations. No immediate health or safety concerns were observed. Exit interview conducted. Copy of report provided.

At 9:50 a.m. on 07/09/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the administrator designee and disclosed the reason for the visit. 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. 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 26 27 28 29 30 31 32 The facility has two (02) bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instructions, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid mat in the shower. At 12:15 p.m. LPA measured the water temperature in Bathroom #1 to be 115.5 degrees Fahrenheit. 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.

At 11:00 a.m. on 11/06/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out. No immediate health and safety hazards were noted during the time of the visit. At 8:45 a.m. today prior to the visit, a file review was conducted of facility documents including but not limited to the Plan of Operations, Dementia Care Plan, Mitigation Plan, Liability Insurance, Facility Application, Facility Sketch, Fire Clearance, Facility Profile, and Personnel Report. A current copy of the facility’s liability insurance was obtained at 12:30 p.m. today. The facility was last visited on 09/08/2022 for a case management visit. It is a single story building with 6 bedrooms, 2 bathrooms, kitchen, laundry room, garage, common areas, and outdoor areas. It has an approved fire clearance for 6 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 11:15 a.m. today, LPA obtained documents including but not limited to the staff roster, resident roster, and resident files for review. 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 6 bedrooms. 2 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. 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 26 27 28 29 30 31 32 The facility has 2 bathrooms. 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 mat in the shower. LPA observed an adequate supply of perishable and non-perishable foods in the kitchen and garage refrigerators, freezers, and pantries. The stove hood was clean. Appliances were in good condition. Sharps were locked below the sink. 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. Walls, floors, windows, screens, and blinds were clean and in good repair. At 12:10 p.m. LPA measured the room temperature to be 77.5 degrees Fahrenheit. LPA observed a covered patio area in the rear of the facility with one (01) resident utilizing the area. The patio contained furniture in good condition. The ramp which led to the emergency exit was in good repair. All emergency exit paths were free from obstructions. Exit gates were unlocked with self-closing latches. At approximately 12:20 p.m. the dual-purpose smoke and carbon monoxide detector was tested and operational. Between 11:45 a.m. and 12:20 p.m. three (03) out of three (03) auditory alarms were on and functioning. During today's inspection, the facility was in compliance with Title 22 regulations. Exit interview conducted. Copy of report provided.