Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the two caregivers. LPA stated the purpose of the visit was to conduct an annual inspection. The Administrator arrived at 10:55 am. The staff confirmed there are three residents. The facility is licensed for six (6) non-ambulatory, bedridden residents.

LPA Spaeth and the caregiver toured the facility at 10:10 am until 11:19 am.

Common Areas – The living room and family room contained comfortable seating. A dining room table with chairs are located in the kitchen. The family room contained a television.

Kitchen - LPA Spaeth observed a two day supply of perishable food and a seven day supply of non-perishable foods. The knives and cleaning solutions were securely locked underneath the kitchen sink. The fire extinguisher is located in the kitchen and is operable.

Medication - LPA observed the resident medications, first aid kit, and PPE supplies were safely locked in a kitchen cabinet..

Garage//Washer & Dryer – The laundry room was locked and contained the washer/dryer. The door leading to the garage was locked. The garage contained the laundry detergent and an additional refrigerator.