Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregiver. The Administrator was called and LPA stated the purpose of the visit is to conduct an annual inspection. The facility is licensed for five non-ambulatory residents and one bedridden resident. LPA confirmed there are five residents in the facility.

LPA and the caregiver toured the facility at 10:15 am until 10:55 am.

Kitchen - LPA Spaeth observed a two-day supply of perishable food and a seven day supply of non-perishable food. The knives were locked in a kitchen drawer. The cleaning solutions were locked underneath the kitchen sink. The fire extinguisher is located near the kitchen and is operable.

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.

Residents’ Rooms – The rooms contained a bed, linens, night stand, lamp, chest of drawers and a closet.