Facility Evaluation Report

Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a health and safety check on the residents at the facility. LPA was greeted and granted entry by staff and explained the reason for the visit. LPA toured the facility. LPA observed resident rooms have the required furnishings. LPA observed resident rooms are clean and organized. LPA observed resident bathrooms are clean and operational. LPA observed the kitchen is clean and organized. LPA observed sufficient non-perishable food and perishable food at the facility for residents. LPA observed utilities on and operational. LPA observed one resident in the living room and two residents in their rooms.

Licensee Gary Bergum lives at the facility and notified LPA of his intention to close the facility. LPA explained to licensee the process of closing including providing a 60 day eviction notice to all residents and/or their responsible parties, informing the Department of when the notices were issued, and a final closure inspection by the Department once the last resident leaves the facility.

This report was discussed with the facility representative and a copy was provided.