Facility Evaluation Report

On 02/04/2026 at 11:00 AM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Administrator Chad Montgomery and explained the purpose of the visit.

LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms 1 of which are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 119 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents.

Smoke detectors and carbon monoxide detectors were in operating condition during visit. First aid kit was observed to be complete. Fire extinguisher was last serviced on 10/09/2025. Emergency drills are conducted quarterly. Last drill conducted on 12/12/2025.

LPA reviewed two (2) resident records, and five (5) staff records, all were complete.

Exit interview conducted and a copy of this report provided.