Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the staff member. Staff member called the Administrator who stated would not be able to come to the facility until 3:00 pm. At 10:20 am, LPA Spaeth spoke to the licensee, Anne Gregorio who stated will be reporting to the facility. LPA stated the purpose of the visit is to conduct an annual inspection. The facility is licensed for five (5) non-ambulatory residents of which one may be bedridden. LPA confirmed there are four residents in the facility.

LPA Spaeth observed another person living in the facility. The staff member confirmed the other person living there is a relative of the staff member. However, LPA observed the relative's name was not listed on the Facility Personnel Report Summary. LPA Spaeth spoke to the Licensee and stated the relative would have to leave the facility and not return until the criminal record clearance had been completed. The Licensee arrived at 11:00 am. The Administrator instructed the relative they would have to leave the facility until the clearance has been completed. LPA observed the relative left the facility at 11:15 am with the Licensee.

LPA and the staff member toured the facility at 10:10 am until 10:50 am. LPA Spaeth observed the following:

Kitchen - LPA Spaeth observed a two day supply of perishable food and a seven-day supply of non-perishable canned goods. At 10:20 am, LPA observed the medication cabinet was not locked. LPA instructed the caregiver to lock the cabinet. At 10:25 am, LPA observed the knives were stored in the pantry and the pantry was not locked. The staff member locked the knives in the medication cabinet.

Common Areas –The living room and dining room are combined and contained comfortable seating along with dining room table and chairs. The family room contained comfortable seating and a television.