Facility Evaluation Report

At approximately 2:15 PM on 03/16/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with staff and later Administrator and disclosed the reason for the visit. LPA and staff toured the facility inside and out.

The facility is a single-story building with 4 bedrooms, 2 bathrooms, a living room, office space, dining room, kitchen, garage, and a back yard. The facility has auditory devices on all exit doors. The facility has a fire clearance for 4 ambulatory consumers.

Upon entry, LPA was screened for symptoms of COVID-19 and temperature checked. Staff recorded LPA name and temperature. The facility’s screening station contained surgical masks, N95 masks, and hand sanitizer. All staff were wearing surgical or N95 masks. Postings for personal rights, grievance procedure, confidential complaints, abuse reporting instructions, facility license, and Ombudsman contact were visible at the front. LPA also observed signs for the facility’s COVID precautions, activity schedule, and a monthly menu.

Bedrooms: All bedrooms were private bedrooms, and all bedrooms were clean and free from debris. Bedroom #1 and Bedroom #3 had windows without screens. The windows in both rooms had locks which restricted the window from opening or closing further. The screen to the window of Bedroom #3 was observed on the ground outside. Bedroom #3 also had black padding on the walls. All bedrooms contained a chair, nightstand, lamp, dresser, adequate storage, and beds with adequate bedding available.