Facility Evaluation Report

On 02/06/2025 at 10:00 AM, Community Care Licensing Division (CCLD) conducted an unannounced annual inspection visit at the Active Board and Care Facility. CCLD staff was allowed entry into the facility by Administrator Candice Michelson. Administrator Michelson asked infection control questions and took CCLD staff temperature prior to entrance into the facility. The facility is licensed for (6) non-ambulatory residents and (1) bedridden residents. The facility has an approved hospice waiver for (1) residents. Currently, there are four (4) residents residing in the facility.

CCLD staff explained to Administrator Michelson, the purpose of the one-year Annual Inspection visit, and escorted CCLD staff on a tour of the entire inside and outside facility grounds. As part of the inspection, CCLD staff reviewed: Four (4) residents service records, four (4) residents medication records (MAR), three (3) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 12/15/2024 . The one-story residential home consists of three (3) resident bedrooms, two (2) resident bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area.