Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by Staff Bryon White and explained the reason for the visit. The purpose of the visit is to complete the required inspection.

LPA Trueman toured the facility along with Staff Bryon White today 05/19/2026 at 12:45 PM and the following was observed:

Facility contains 8 Client Bedrooms and 4 Client Bathrooms, dining room, living room, and TV room.

Annual Inspection includes the following Domains:

Infection Control, Physical Plant and Environment Safety, Operational Requirements, Staffing, Personnel Records- Training, Client Rights Information, Client rights- Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness, and Emergency Intervention. 5 client files and 6 staff files were reviewed

Hot water temperature measured between 115 F.-120 F. in client bathrooms.

Medication was administered per physician's directions. LPA reviewed medication for 5 Client's.

Signage for hand washing and proper sanitizing were posted. Staff have been trained in hand washing.

Staff responsible for providing care and supervision received training in First Aid.

Licensee maintained an individual admission agreement for each client.

Facility had sufficient supply of 2 day perishable and 7 day non-perishables meeting regulations.

Each client has personal rights free from corporal or unusual punishment, infliction of pain, humiliation, ridicule, coercion, threats, mental abuse, or other actions of a punitive nature.

Program site was clean, safe, sanitary, and in good repair at all times for the safety and well being of clients, employees and visitors.

No deficiencies. Exit interview conducted and copies provided.