Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to the facility today to conduct an Annual Required inspection. LPA was greeted and granted entry and explained the reason for the visit.

The facility is a single story building with an approved fire clearance of six non-ambulatory clients. The facility currently has a census of six clients in care.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing the hot water temperatures in bathrooms. The hot water temperatures measured between 107.6 to 110.4 degrees Fahrenheit. LPA observed all smoke detectors were operational. The facility’s last emergency drill was conducted on April 22nd 2026. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed deep freezer and second refrigerator in the detached garage. LPA observed secured medication storage in activity room. LPA observed emergency food in kitchen pantry and emergency water stored in staff bedroom.

LPA reviewed four out of four staff training and fingerprint records. LPA conducted a complete review of client

records. LPA confirmed that administrator has a current administrator certificate which expires on November 4th 2027.

Based on the observations made during today’s visit no deficiencies cited on this date . An exit interview was conducted with Theodora Fredericksen, Administrator and a copy of this report was provided.