4Th Generation Senior Living

Type of visit: Required - 1 Year

At approximately 9:00 a.m. on 10/17/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with the administrator and disclosed the reason for the visit. The facility was last visited on 07/17/25 for a complaint visit. It is a single story building with seven (07) bedrooms, three (03) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents, of which one (01) may be bedridden. The facility serves residents with dementia. Approved hospice waivers for five (05). Surveillance cameras are used in common areas. The front entrance was gated and unlocked. The front yard was maintained with gardened areas and free of hazards. At the front door, LPA observed postings for the house rules, visitation policy, facility sketch, facility license, COVID precautions, rights of resident councils, personal rights, ombudsman contacts, emergency disaster plan, personal rights, and administrator certificates. A screening station at the front contained a visitor log, sanitizer, digital thermometer, and masks. Walls, floors, windows, screens, and blinds were clean and in good repair. At 9:10 a.m. LPA measured the room temperature to be 72 degrees Fahrenheit. The living room contained a television, reading materials, and furniture in good repair. Activities were set up on the dining room table. Hallway closets contained adequate supplies of fresh linens and extra supplies. A locked closet near the main entrance contained confidential files, medications, and a fully-stocked first aid kit. At 9:20 a.m. LPA successfully called out from the house telephone and deemed it operational. The facility has seven (07) bedrooms. One (01) bedroom served as a staff room. The staff room was 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. Exit doors from rooms were unlocked. A resident in Bedroom #3 had full bed rails. The facility has three (03) bathrooms. Two (02) bathrooms are private, and one (01) is shared. Bathrooms contained liquid soap, trash cans with tight fitting lids, bidets, grab bars near the toilet and shower, and a non-skid mat in the shower. At approximately 9:30 a.m. LPA measured the water temperature in the shared bathroom to be 118.2 degrees Fahrenheit. LPA observed an adequate supply of perishable and non-perishable foods in the kitchen refrigerators, freezers, and pantry. A weekly menu was posted on the refrigerator. At 11:35 a.m. LPA measured the refrigerator temperature to be 34 degrees Fahrenheit. Appliances were clean and in good condition. Sharps were locked below the counter top. Cleaning solutions and detergents were locked in the laundry area adjacent to the kitchen. The laundry area contained a washing machine and a dryer in working order. At 11:40 a.m. LPA observed three (03) residents in the living room watching television. Lunch was served at 11:45 a.m. Lunch was observed to contain a variety of nutritious proteins, fruits, and grains. LPA overheard the administrator offering residents multiple choices for lunch. At 12:45 p.m. the combination carbon monoxide and smoke detectors were tested and operational. At 12:55 p.m. a fully-charged fire extinguisher was observed in the kitchen. Four (04) out of four (04) auditory alarms were on and functional. Two (02) seating areas in the rear were shaded with furniture in good repair. One of the seating areas had a mosquito net around it. The back yard also contained a gardened area, exercise equipment, and a gas grill. The garage was locked and contained tools and extra supplies. A shed was also locked and contained additional supplies. The emergency exit path was free of hazards. The exit gate was unlocked. At 12:30 p.m. LPA conducted a records review of resident and personnel files. All files were complete and available for audit. During today’s inspection, no immediate health or safety hazards were observed. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Oct 17, 2025

Allegation investigated: Staff are doing wound care for resident Staff are doing finger pricks for resident Staff are not properly preparing food

At approximately 9:30 a.m. on 07/17/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the administrator and disclosed the reason for the visit. To investigate the allegations above, LPA conducted an initial visit on 04/09/25 and interviewed Staff #1 (S1) at 10:15 a.m., Resident #2 (R2) at 10:30 a.m., Resident #3 (R3) at 10:40 a.m., and the licensee at 3:00 p.m., conducted a record review of pertinent records, including but not limited to a medical assessment, care plan, home health and hospice files, and a client roster at 11:00 a.m., and toured the facility inside and out at 10:45 a.m. Today, LPA toured the facility at 9:45 a.m., interviewed the administrator at 10:00 a.m., Staff #2 (S2) at 2:30 p.m., and two (02) other residents between 2:40 p.m. and 3:15 p.m. Regarding the allegation "Staff are doing wound care for resident" it was alleged staff were performing wound care for Resident #1 (R1) without proper training. Record review of R1’s hospital discharge record from 02/24/25 indicated they had a healing, unstageable pressure injury on their sacrum. Unsubstantiated Review of R1’s hospice plan of care revealed R1 obtained hospice services on 03/12/25. R1 was unavailable for interviews during the course of investigation. Interview with the licensee revealed all staff were trained on daily skin care for R1 and only assisted with skin care which was ordered by the physician. Interview with the administrator confirmed that all staff received training on R1’s skin care which consisted of patting dry and applying a skin ointment. Record review of R1s hospice documents revealed their physician prescribed orders for Calmoseptine skin ointment and staff were instructed to ”apply a thin layer of Calmoseptine topical… daily and as needed…for skin care”. Interviews with S1 and S2 confirmed they followed physician orders for R1’s skin care and they attended the training provided by the hospice nurse. Based on interviews and record review, although the allegation is valid, there is not enough evidence to verify it is true. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation "Staff are doing finger pricks for resident" it was alleged staff checked the blood sugar level of R2 by pricking their finger. Interview with R2 did not reveal any pertinent information to the investigation. Interview with the licensee confirmed R2 used to do their own blood sugar level checks without staff assistance. Interview with the administrator confirmed R2 used to perform their blood sugar lever checks independently. R2 later acquired home health services to perform checks about once a week. Record review of R2’s home health orders revealed staff were to “assess compliance to regular finger stick blood sugar checks”, and the home health nurse was to assist with blood sugar checks. Record review of R2’s home health visit logs revealed that a home health nurse visited R2 about once a week since 08/01/24 to check R2’s vitals and blood sugar levels. Interview with S1 and S2 revealed they have never performed finger pricks on R2. No residents interviewed ever witnessed staff perform blood sugar checks on R2. Based on interviews and record review, R2 receives assistance form their home health care provider for blood sugar checks, and staff have not performed finger pricks. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation "Staff are not properly preparing food" it was alleged food was cooked and left out all day to spoil. During facility tours on 04/09/25 and today, LPA observed adequate supplies of perishable and non-perishable foods which were properly stored. All food was in good condition. Interview with the licensee and administrator noted food is always prepared and stored properly. Spoiled food is thrown out. Interviews with four (04) out of four (04) residents interviewed revealed the food is good quality and to their likings. Based on observations and interviews, the facility prepares food properly. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. No immediate health or safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 17, 2025 · control 31-AS-20250404124716

Type of visit: Required - 1 Year

At approximately 12:20 p.m. on 09/28/24 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with staff and later the administrator and disclosed the reason for the visit. The facility was last visited on 09/21/22 for an annual visit. It is a single story building with seven (07) bedrooms, three (03) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents, of which one (01) may be bedridden. The facility serves residents with dementia. Approved hospice waivers for five (05). Surveillance cameras are used in common areas. The front entrance is gated and unlocked. The front yard is maintained and free of hazards. At the front door, LPA observed postings for the house rules, visitation policy, facility sketch, facility license, COVID precautions, rights of resident councils, personal rights, ombudsman contacts, emergency disaster plan, personal rights, and administrator certificates. A screening station at the front contained a visitor log, sanitizer, digital thermometer, and masks. Walls, floors, windows, screens, and blinds were clean and in good repair. At 12:30 p.m. LPA measured the room temperature to be 73 degrees Fahrenheit. The living room contained a television, reading materials, and furniture in good repair. Activities were set up on the dining room table. Hallway closets contained adequate supplies of fresh linens and extra supplies. A locked closet contained confidential files, medications, and a fully-stocked first aid kit. At 12:40 p.m. the house telephone was called and deemed operational. LPA observed an adequate supply of perishable and non-perishable foods in the kitchen refrigerators, freezers, and pantry. Appliances were clean and in good condition. Sharps were locked below the counter top. Cleaning solutions and detergents were locked in the laundry area adjacent to the kitchen. The laundry area contained a washing machine and a dryer in working order. At 12:50 p.m. the combination carbon monoxide and smoke detectors were tested and operational. At 12:55 p.m. a fully-charged fire extinguisher was observed in the kitchen. All auditory alarms were on and functional. Two (02) seating areas in the rear were shaded with furniture in good repair. The back yard also contained a gardened area, exercise equipment, and a gas grill. The garage was locked and contained tools and extra supplies. Emergency exit paths were free of hazards. The exit gate was unlocked. The facility has seven (07) bedrooms. One (01) bedrooms served as a staff room. The staff room was 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. Exit doors from rooms were unlocked. The facility has three (03) bathrooms. Two (02) bathrooms are private, and one (01) is shared. Bathrooms contained liquid soap, trash cans with tight fitting lids, bidets, grab bars near the toilet and shower, and a non-skid mat in the shower. At approximately 1:00 p.m. LPA measured the water temperature in the shared bathroom to be 106.2 degrees Fahrenheit. At 1:15 p.m. LPA conducted a records review of resident and personnel files. All files were complete and available for audit. During today’s inspection, no immediate health or safety hazards were observed. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Sep 28, 2024