Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by receptionist. LPA met with Eric Jensen, Executive Director, and LPA explained the nature of the visit. Facility is licensed for building A floors 1-5 with 200 non-ambulatory residents, of which 15 may be bedridden. Facility has an approved hospice waiver for 20 residents. The facility currently has 74 residents and 7 residents are on hospice during today's visit.

LPA Martinez along with Executive Director toured the inside and outside of the physical plant of the facility. LPA observed a dining room on the first floor. LPA observed menus posted and the food offered is varied and healthy. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Maintenance records were observed in the main kitchen. During the tour LPA observed residents involved in activities as well as a posted activity schedule including games, exercise, and outings at the facility. LPA inspected that medication is centrally stored in a safe locked location; facility has a medication room on the 2 nd floor. LPA observed and inspected medication carts that are used to dispense meds to residents and observed medication was labeled and stored inaccessible to residents in care. First aid kit was observe in the medication room and mounted on the wall throughout the facility First aid manual kept and observed in the medication room. he facility has apartment style bedrooms for residents. LPA inspected apartments; all required components were observed in inspected apartments. Each apartment has their own bathroom, LPA inspected resident bathrooms. Toilets and water faucets worked properly, grab