Facility Evaluation Report

On 11/15/23, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA introduced self and allowed entrance by Administrator Russ Sedam.

Currently, 4 residents in placement. All residents present during today's inspection and observed to be interacting with staff.

LPA conducted a complete tour of the facility with Administrator. Facility was observed at a comfortable temperature, clean, in good repair. Resident rooms toured and observed to have required furnishings. Bathrooms observed in good repair and operational. Showers observed to be equipped with non-skid mats. Hot water was measured at 120 degrees F. Common areas were properly furnished and well-lit throughout. Kitchen observed to have adequate food supply for residents in care. All knives are locked and secured in closet near dining room. Medications observed to be locked and secured in medication cart. All medications observed to have original labels and be administered as prescribed.

Smoke detector and carbon monoxide detector observed operational at time of inspection. Fire extinguisher has a service date of 5/16/23. Last fire drill conducted on 9/27/2023 according to facility records.

Outside toured. All exits open free of obstruction. No hazards observed

No deficiencies observed. Exit Interview conducted with Administrator and a copy of report provided for facility records.