Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the Administrator. LPA stated the purpose of the visit was to conduct an annual inspection. The Administrator confirmed there are four residents living in the facility. The facility is licensed for six (6) ambulatory clients.

LPA Spaeth and the caregiver toured the facility at 12:45 until 1:15 pm.

Common Areas – The living room and dining room are combined. The living room was furnished with comfortable seating. The dining room contained dining room table and chairs. The family room contained a television and comfortable seating.

Medications: LPA observed the resident medications, first aid kit, and knives were safely locked in a filing cabinet in the living room.

Kitchen – LPA observed a two day supply of perishable food and a seven day supply of non-perishable food items. The fire extinguisher was located near the kitchen and was operable.

Hallway - The linens were located in a hallway cabinet.

Laundry Area – The laundry room was locked and contained the washer/dryer and the laundry detergent. The door leading from the laundry room to the garage was locked.

Garage – LPA observed an additional freezer was located in the garage.

Bathrooms : There are two (2) client bathrooms and one staff bathroom. All bathrooms were well lit, clean, contained hand soap, paper towels and trash bins with lids. The water temperature was tested at 12:55 pm and was 119.0 degrees F.