Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit and was greeted by a caregiver. The facility is licensed as an adult residential facility to serve three ambulatory clients and one non-ambulatory client.

LPA and the caregiver began the tour of the facility at 9:10 am until 9:55 am. LPA observed the following:

Living Room – LPA Spaeth observed the living room contained comfortable seating.

Kitchen/Dining room - The dining room and kitchen are combined. LPA Spaeth observed a seven-day supply of non-perishable food and a two-day supply of perishable foods. The fire extinguisher is located in the kitchen.

Hallway Closet - The closet was locked and contained the knives, client medications and the first aid kit.

Laundry Room - The laundry room was locked and contained laundry soap, washing machine, dryer, client hygiene items, additional PPE, and cleaning supplies.

Bathrooms – LPA Spaeth observed the bathrooms contained hand soap, paper towels, and a trash can. LPA tested the water temperature at 10:29 am and was 106.0 F.

Bedrooms – LPA Spaeth observed there are four client bedrooms in the facility. The bedrooms contained bed, linens, night stand, chair, chest of drawers, and a night lamp.

Office – LPA observed the staff office was locked