Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with Administrator Russell Johnsrud and explained the reason for the visit.There are six (6) developmentally disabled clients who reside in the home of which six (6) are ambulatory. The facility is a single-story home located in a residential neighborhood that is licensed for a capacity of six (6) ambulatory clients. It consists of four (5) client bedrooms of which two are shared, a living room, a dining room, a kitchen, two (2) shared bathrooms, a front yard area, a back patio area, and a separate detached garage.

LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Smoke detectors were observed in each room and throughout the facility and are properly operating. There is 1 carbon monoxide in the hallway and is properly operating. The facility has two (2) fully charged fire extinguishers which is kept in the kitchen and hallway. Cleaning supplies and toxic substances are inaccessible to clients in a locked storage area in garage. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 45 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked in a box and placed in drawer in kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The garage is clean and has an extra refrigerator.

Four (4) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Three (3) Client files were reviewed and included physicians report, TB clearance, and individual program plan (IPP)report. Last fire/earthquake drill was conducted in 4/12/26 . Infectious control plan was reviewed. The medications are centrally stored and locked in a cabinet in kitchen. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for all clients, and they are being administered as prescribed by the physician.

No deficiency was observed during today’s visit. Exit interview was conducted with Administrator and a copy of report was provided.