Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit and was greeted by the caregiver. The facility is licensed as an adult residential facility to serve four ambulatory clients.

LPA and the caregiver began the tour of the facility at 8:45 am until 9:20 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 first aid kit, emergency water and food.

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.

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