Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Staff#1 upon arrival and Administrator Ewa Nyczak join shortly after. LPA explained the reason for the visit to Administrator. Facility annual fees are current.

The facility is licensed to serve six (6) elderly clients ages 60 and above with a hospice waiver for three (3) residents. Dementia waiver is in place. Today’s inspection consisted of applying CARE tool, conducting physical plant, reviewing staff/residents records, checking residents’ food supply/medication, and interviewing staff/residents.

Facility maintains an infection control plan was on file. Staff were observed practicing safe hand washing. Hand sanitizing was observed throughout. Hygiene supply and sanitizing materials were observed.