Facility Evaluation Report

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct the Required Annual Inspection. LPA was granted entry into the facility by Staff Alma Arrula. LPA contacted Licensee Dina Fay Crandell via telephone who gave permission for Staff Marvin Killian to assist with the visit. Staff Marvin Killiam responded to the facility and met with LPA.

A tour of the facility was conducted with the Staff. The residence was set at 78 F temperature and free of passageway obstructions inside and outside.

LPA Doucette observed 5 bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean. Hot water temperature was measured 105 F.

Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Knives were stored in a locked closet. Medications were stored in a locked cabinet in the kitchen. Cleaning supplies were in a locked in laundry room. Smoke detectors and carbon monoxide detectors were checked and operating. Facility has a pull station fire alarm. Fire extinguishers were charged and had service dates of 1/2/24. Fire drill was last completed on 5/1/24.

LPA observed a self latching gate on the outside of the residence. There was outdoor seating for the residents.

Resident and medication records were reviewed. LPA was unable to review staff records or staff training due to the records not being accessible.

An exit interview was conducted with the Staff. A copy of this report was discussed with the Staff, Marvin Killiam, whose signature on this form confirm receipt of these documents.