Ingleside by the Lake

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) De Leon arrived at 10:30am to annual visit to the facility above. LPA met with Administrator Nikole Daughtery and explained the purpose of the visit. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Infection Control: The facility has a current Infection Control Plan. The facility has a sign in and out binder for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, and hand soap. The facility has EPA approved disinfectant spray and cleaners. The facility has a 30-day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). Physical Plant & Environment Safety: LPA toured 6 residents room, 3 on suite bathrooms, and 1 main resident restroom. The fire extinguisher were charged and tagged on 03/11/2026. LPA was authorized to enter and inspect facility. The facility has dual smoke and carbon monoxide detectors with sprinkler system. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have non-skid mats or textured bottoms. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents in care and stored in locked storage rooms. The facility has sufficient space inside and outside for activities and visiting. The facility has a patio with furniture, walkways and shaded areas for resident use. The facility has a pool that is fully fenced with 2 locked gates. The facility has a hot tub with a hard locked closed lid. The facility has a locked staff restroom. The facility has telephone and internet service for resident use. The facility has 3 locked supply closets which contain cleaning products and supplies. Continued 809-C Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 06/16/2026. The facility is approved for a capacity of 6 with 6 being non-ambulatory and may be bedridden. Hospice is approved for 6 residents. Staffing: The facility currently employes 10 staff and 1 Administrator. Staff records are kept confidential. Five staff files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, and fingerprint clearance or exemptions.. Personnel Records & Training: The facility keeps confidential files for each staff member. Staff have annual training completed for 20 plus hours from 05/2025-05/2026. Resident Records & Incident Reports: The facility keeps separate files on each resident confidentially. Facility does submit incident reports to the department when required. LPA reviewed 5 resident files for signed Admission Agreements, Safeguard for property and valuables, LIC. 602A Physicians report, Appraisals Needs and Services Plan, and Emergency and ID forms. Food Service: The facility handles and prepares food safely. The facility has 2-day perishables and 7-day non-perishables. The freezer is kept at 0 degrees and the refrigeration is kept at 40 degrees or lower. All food is covered, stored and marked appropriately. Cleaning solutions and equipment are stored separately from food supplies. The facility has an emergency food and water supply. Incidental Medical Services: Facility provides assistance in arranging transportation to medical and dental appointments when needed. The facility uses the Medication Administration Record (MAR) along with the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed all 6 residents medications, no labels were altered, no medications were expired and all medications were kept in their original containers. Disaster Preparedness: The current emergency disaster forms were posted. The facility conducts quarterly disaster drills. Emergency exits and telephone numbers were posted. Disaster plan reviewed annually and is signed off by Administrator. Residents with Special Health Needs: The facility does accept dementia residents in care, all sharps, knives, cleaning products and items that can pose a hazard are locked in drawers and closets. The facility currently has 1 resident on a PRN oxygen and sign is posted. The facility has 1 resident on hospice services. The facility currently has 4 residents on home health services. Hospice and Home Health Plans are kept up to date and on file at the facility. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, May 21, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) De Leon arrived at 9:30 am to conduct a 1 year annual visit to the facility above. LPA met with Administrator Nikole Daugherty and explained the purpose of the visit. Staffing: The facility currently employes 8 staff, and 2 Administrators. Staff records are kept confidential. Five staff files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, and fingerprint clearance or exemptions. Personnel Records & Training: The facility keeps confidential files for each staff member. Staff have annual training completed for 20 plus hours from 06/2024-06/2025. LPA will need additional time to complete the annual visit and will return at a later date. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Jun 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Miller arrived at 2:00 pm and made an unannounced 1-year required annual visit to the facility above. LPA met with Janet Johnson, house manager and explained the purpose of the visit. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Infection Control: The facility has a current Infection Control Plan. The facility has a sign in and out binder for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, hand soap, and hand washing signs. The facility has EPA approved disinfectants sprays and cleaners. The facility has a 30-day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). Physical Plant & Environment Safety: The fire extinguishers were last charged and inspected on April 3, 2024. All trash cans wastebaskets have tight fitting lids. The facility has 6 bedrooms with 3 ensuite bathrooms currently occupying 6 residents. There is 1 locked staff bathroom and is inaccessible to residents. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors that were tested. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have non-skid mats. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions are inaccessible to residents in care and are locked in a storage closet in bathroom 4. The facility has sufficient space inside and outside for activities and visiting. The facility has a fenced backyard for client use with plenty of shade. The pool is fenced and the hot tub is inaccessible to residents in care. The facility has telephone and internet service for resident use. Continued 809-C Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility is approved for a capacity of 6. The fire clearance is granted for 6 non-Ambulatory of which 6 may be bedridden. A hospice waiver is approved for 6 residents. The facility currently has 1 ambulatory, 5 non-ambulatory and 1 hospice resident. Staffing: The facility currently employs 7 full time direct care staff and 1 administrator. Staff records are kept confidential. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance/associations/exemptions. Administrator file was reviewed for Continuing Education requirement and Administrator Certificate expires June 17, 2024. Personnel Records & Training: The facility keeps confidential files for each staff member. Staff have annual training completed for various subjects/topics and hours for 2023 and 2024. Resident Records & Incident Reports: The facility keeps separate files on each resident confidentially. Facility does submit incident reports to the department when required. LPA reviewed 5 resident files for signed Admission Agreements, Personal Rights, Safeguard for property and valuables, Physicians report, Pre-appraisals, Appraisals Needs and Services Plan, Emergency and ID forms. All forms were legible. Food Service: The facility handles and prepares food safely. The facility has 2 day perishables and 7 day non-perishables to meet the food service requirement. The freezer is kept at 0 degrees and the refrigeration is kept at 40 degrees or lower. All food is covered, stored, and marked appropriately. Cleaning solutions and equipment are stored separately from food supplies. Continued 809-C Incidental Medical Services: Facility provides transportation or assists in providing transportation to medical and dental appointments when needed. The facility uses the Medication Administration Record (MAR) along with the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed residents' medications, no labels were altered, no medications were expired and all medications were kept in their original containers. Disaster Preparedness: The current emergency disaster forms were posted. The facility last conducted a quarterly disaster drill May 23, 2024. Emergency exits and telephone numbers were posted. A set of keys is available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care. The facility does not have delayed egress, locked doors or gates. Exit door alarms are working. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Jun 17, 2024