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 staff. Brigette Fisk and Ryan Fisk, Administrators, arrived shortly after and met with LPA. There are six (6) residents at the facility and there is two (2) residents receiving hospice services currently.

The facility is a one-story house with an attached garage. The facility has six resident bedrooms currently assigned to be private. There is also one staff bedroom in use by the awake night staff. LPA observed residents in the dining room having breakfast. LPA accompanied by staff began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in a freezer in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the laundry unit. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed the first aid kit. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 114.8 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked in the laundry unit. LPA