Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the Administrator. LPA stated the purpose of the visit was to conduct an annual inspection. The Administrator confirmed there are four residents. LPA observed two clients waiting for transportation to their adult day program. LPA observed the two were picked up at 9:00 am and 9:10 am. The Administrator confirmed the other two residents had been picked up to attend the adult day program prior to LPA's arrival. The facility is licensed for four (4) ambulatory residents.

LPA reviewed the residents' files and P & I at 8:45 am until 9:15 am. LPA Spaeth viewed staff files at 9:20 am until 9:55 am. LPA reviewed client's medications at 10:00 am.

LPA Spaeth and the caregiver toured the facility at 10:10 am until 10:45 am.

Common Areas – The living room and family room contained comfortable seating. The dining room contained a dining room table with chairs. 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 cabinet.