Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Panushkina conducted an annual visit, met with the Administrator and explained the reason for the visit.

A tour of the physical plant was initiated at 10:45am and the following were observed:

The facility maintains a comfortable temperature at 70°F. LPA was informed that the facility did not have any residents since September 2025.

KITCHEN: The kitchen area that is equipped with a refrigerator, microwave oven and sink. All sharps observed to be locked in a kitchen drawer. All chemicals are locked under the kitchen sink and or in the garage and kept inaccessible to residents in care. The fire extinguisher is located in the kitchen and was last purchased on 03/31/2026

BEDROOMS: The facility has five (5) bedrooms designated for residents’ use. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and lighting. Room #6 is designated for live-in staff.

BATHROOMS: The facility has three (3) bathrooms. LPA observed all bathrooms have non-skid mat, soap, paper towels and hand washing signs. Extra towels and linens were readily available.

MEDICATION ROOM: At approximately 11:00am, LPA observed medications are centrally stored and locked, in the hallway closet and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. Continue on LIC809-C