The first warning signs were the grimy dentures and the tangled hair.
In mid-February, Haley McDonald was visiting her 96-year-old great-grandmother, Gertrude Moore, at Moraa's Home for Seniors when she first started feeling something wasn't right with Moore's care.
McDonald's aunt had only admitted Moore to the small assisted living facility a few days before, but McDonald already had noticed a difference in her great-grandmother's hygiene and her demeanor.
Two days later, McDonald was visiting again when she, her mother and grandmother saw Moraa's primary -- and usually only -- caregiver roughly hoist another elderly woman out of a wheelchair and throw her onto the bed.
"I started crying, and I didn't even know the lady," McDonald said. "Gertrude speaks German, and so my grandmother told her in German right then that we were going to get her out."
At the hospital, physicians found that Moore was dehydrated, had a urinary tract infection, and that her blood lacked any sign of the medication she was supposed to be on. They also found bruising on her legs and ankles, where Moore said one caregiver had shaken her.
Moore's removal from Moraa's Home prompted Collegedale Police Department to join the state's Adult Protective Services in an investigation that culminated Tuesday in the arrests of owners David and Agnes Machoka and their only employee at the 24-hour facility, Margaret Adhiambo.
Each was charged with two counts of physical abuse and gross negligence and six counts of willful abuse, neglect or exploitation.
Neither the Machokas nor Adhiambo, who bonded out of jail Tuesday, could be reached for comment Wednesday. The Machokas, who are originally from Kenya, started Moraa's Home in 2010, state records show.
The small one-level house perched on a hill off Apison Pike is licensed as a "home for the aged," which in Tennessee means that residents are ambulatory, mentally aware of their surroundings and can medicate themselves.
But investigators found that none of the women who lived there -- between ages 66 and 101 -- were ambulatory. Two had Parkinson's disease and several were in various stages of dementia.
"These people could not feed themselves. They definitely could not medicate themselves," said Collegedale Police Detective Kat Cooper.
She said the state's Adult Protective Services investigators who visited said the Moraa's Home workers are not capable of providing for the patients' level of need.
"They're not licensed to, and they're not trained to," said Cooper. While Agnes Machoka is licensed as a nurse aide in Tennessee, Adhiambo has no license registered with the state's Department of Health.
Yet Moraa's Home was charging most families a minimum of $2,000 per month of care, investigators said.
The home was also in violation of several fire codes and had not corrected prior citations. At one fire drill, marshals found that the residents could not be evacuated safely without significant help from staff.
The home was also licensed to house only six residents, though it held eight before Moore and another woman were moved, investigators said.
Cooper found that the other resident had been hospitalized a month earlier and was missing critical medication from her system.
While Collegedale police can press criminal charges against the caregivers, the status of Moraa's home is in state officials' hands.
No one at the state Department of Health would confirm Wednesday whether the home was under investigation or in the process of being closed.
While family members of the six remaining women were able to transport them from the home before it was vacated, Cooper said several found themselves at a loss.
"A lot of these families, they don't want to think their loved ones were abused or neglected," said Cooper. "At the same time, it's also really scary for them to think, 'What are we going to do now? How are we going to care for them? Are we going to be able to find another facility? Most of the families were in a panic."