Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit on 12/18/2023. LPA was greeted by the caregiver. The facility is licensed for six ambulatory residents and there are five residents living in the facility. Three residents were attending an adult day program and two were in the facility during LPAs inspection.

LPA Spaeth and the Administrator began the tour at 9:40 am until 10:13 am. LPA observed the following:

Common areas – The living room and family room contained comfortable seating. The dining room 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. There were no cleaning solutions stored underneath the kitchen sink. A fire extinguisher was located in the kitchen area.

Pantry Room - The pantry room was locked and contained canned goods on one side of the room and cleaning solutions on the other side of the room. The washer and dryer were located in the pantry room.

Resident Rooms - LPA observed the resident rooms contained bed, linens, night stand, lamp, closet and chest of drawers.

Medications - The medications were locked in a two drawer cabinet located in the dining room.