Facility Evaluation Report

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff Misty Gunderson and explained the reason for the visit. Administrator, Tammy Shirely could not attend the annual for the day due to an emergency. Staff Misty Gunderson is designee to sign off on the licensing report. At approximately 10: 15 am, with the assistance of the staff LPA took a tour of the physical plant. The smoke alarms are interconnected and battery-operated. There is a carbon monoxide detector that functions properly installed in the hallway between clients' rooms. The fire extinguisher is located in the kitchen. The purchase date is 05/28/24.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked cabinet in the kitchen. Properly labeled medications were locked in the kitchen cabinet. Required postings were observed in the kitchen. Bedrooms: The facility has five (5) bedrooms. Three (3) bedrooms are designated for clients' use and two (2) bedrooms are currently being used for staff. All three bedrooms, in use by clients, were properly furnished with appropriate bedding and linens with sufficient lighting. Bathrooms: The facility has three (3) bathrooms. There are two (2) bathrooms designated for clients' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 108.9 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas : This includes the living room dining areas were appropriately furnished and lighting was adequate. The living room has a television and comfortable furniture. The dining room table is large enough to sit the capacity of the facility. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. LPA observed exercise machines for client's use . LPA checked the side gate to insure no locks installed, and that it is clear to exit/evacuate in case of an emergency. The outdoor area was free of hazards. (Continue on 809C)