Facility Evaluation Report

On 08/07/2023 at 1:30 pm, Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced required annual visit. LPA Melissa Spaeth was greeted by caregiver. The facility is licensed as a Residential Care Facility for the Elderly (RCFE) to serve six residents of which five (5) may be non-ambulatory and one (1) may be bedridden. There is a hospice waiver for six residents. The facility currently has four residents. The Administrator arrived at 2:00 pm.

LPA and caregiver began the tour at 1:40 pm until 2:15 pm.

Common areas – LPA observed the living room and family room contain comfortable seating.

Dining Room/Kitchen Combination – LPA observed a seven-day supply of non-perishable food and a two-day supply of perishable food in the refrigerator. At 1:40 pm, LPA Melissa Spaeth observed the kitchen knives were locked in a kitchen cabinet. The resident medications are locked in a kitchen cabinet along with the first aid kit. The cleaning solutions were locked underneath the kitchen sink. The fire extinguisher is located in the kitchen area.

Backyard - LPA observed comfortable seating located in a shaded area. The gate leading from the backyard to the front yard was not locked.

Resident Bedrooms – LPA observed the rooms were neat and clean. The bedrooms contained bed, linens, night stand, night lamp, and closet.

Bathrooms – Both bathrooms contained hand soap, paper towels, trash can, slip resistant mat, and grab bars.

Hallway Closet – This closet contained PPE supplies and linens were also located in a hallway closet.