Facility Evaluation Report

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct an Annual Inspection. LPA was granted entry by Staff Dilyn Stewart. Staff contacted Administrator who responded to assist with the visit.

A tour of the facility was conducted with Administrator. The residence was set at 71 F temperature and free of passageway obstructions inside and outside. Facility was clean inside and out. Resident bedroom have appropriate furnishings.

Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Medications were stored in a locked medication closet in the hallway. Cleaning supplies were in a locked cabinet in the garage.

Smoke detectors and carbon monoxide detectors were checked and operating. Fire extinguishers were charged and had service dates of 01/20/25. Fire drill 08/13/25. Water temperature measured at 117.3 F.

There was outdoor seating for the residents. No pools or bodies of water.

Resident, medication and staff records were reviewed. R1 started a medication on 11/26/25. R1 had 17 pills out of 30 pills left in the PM medication indicating R1 missed 1 PM medication. Current first aid and CPR were reviewed.

A copy of this report was provided to the Administrator with plans of correction and appeal rights.