Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Heidie Tadao and discussed the purpose of the visit. The facility currently has six residents in care.

The facility is a one story home with six resident bedrooms, eight bathrooms, one staff bedroom, kitchen, living room, dining room, staff office, laundry room and attached two car garage. The facility appears clean, safe and sanitary. LPA observed all resident rooms to have the required components and furnishings. LPA observed the restrooms to be stocked with toilet paper, paper towels and nonslip mats in the shower. LPA tested the water in the resident restrooms to be between 109.5 and 113 degrees Fahrenheit. LPA observed a clean supply of linens in the hall by the back door for resident use. LPA observed the kitchen to be clean and free of vermin. LPA observed the emergency food supply to be stored in the kitchen pantry. LPA observed a two day perishable and seven day nonperishable food supply on hand. LPA observed the knives and sharps to be in a locked kitchen cabinet making them inaccessible to residents in care. LPA observed toxins and chemicals to be locked under the kitchen sink and in a locked cabinet located in the laundry room making them inaccessible to residents in care. LPA observed a fire extinguisher by the laundry room charged and with a service date of October 24, 2025. LPA observed the staff bedroom to be unlocked with no objects or medications accessible to residents. LPA observed the centrally stored medication cart to be locked and stored in the staff office making it inaccessible to residents in care. LPA observed the garage to be locked and made inaccessible to residents in care. LPA observed food storage in the garage as well as the emergency water supply. LPA observed the backyard to be free of debris and obstructions. LPA and AD tested the carbon monoxide detector and fire alarms and they were found to be operational.