Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit on 11/05/2025. LPA was greeted by the caregiver. The facility is licensed for six ambulatory residents and there are five residents living in the facility. The caregiver confirmed four residents were attending the day program and one resident was asleep.

LPA Spaeth and the caregiver began the tour at 10:00 am until 10:40 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.

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.

Resident files - The residents' files were locked in a two drawer cabinet located in the dining room.