Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregivers and greeted by the Administrator who arrived at 10:35 am. LPA stated the purpose of the visit was to conduct an annual inspection. The Administrator confirmed there are five residents.. The facility is licensed for a total of six non-ambulatory residents of which two can be bedridden.

LPA Spaeth and the Administrator toured the location at 10:50 am until 11:24 am.

Common Areas – LPA observed the family room, kitchen, and dining room are combined. The family room contained comfortable seating and a television. The dining room section contained a dining room table and chairs.

Kitchen – LPA observed a two-day supply of perishable food and a seven-day supply of non-perishable food items. The medications are locked in a kitchen cabinet. The knives were locked in a kitchen drawer. A fire extinguisher was located in the kitchen area.

Laundry Room – The laundry room was located and contained washer/dryer, laundry soap, and cleaning solutions.

Hallway – The hallway contained cabinets and the clean linens are stored in the cabinet..

Garage - LPA observed the garage was locked. An additional freezer is located in the garage and contained additional frozen food items.

Resident Bedrooms - There are four resident bedrooms which are furnished with a bed, linens, night stand, chest of drawers and a closet. Two residents are currently in the master bedroom (Bedroom #3) along with the master bath.