Facility Evaluation Report

On November 17, 2025, Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by care giving staff after explaining the purpose for the visit. Administrators (ADs) Mark Fisk and Erin Fisk were notified via telephone and later arrived to assist with the inspection. LPA observed that Mark Fisk and Erin Fisk have valid Administrator certificates expiring on January 27, 2026.

The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for four. The facility is a single story home with six bedrooms, four private resident bedrooms, one shared resident bedroom, one staff bedroom, and two bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the AD, conducted a tour of the interior portion of the facility. On today's visit, LPA observed five residents in care and two care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the hallway. LPA inspected the five resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in the hallway closet. LPA inspected both bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 118.4 and 118.7 degrees Fahrenheit. LPA observed the staff bedroom to be kept locked and inaccessible to residents in care.

LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. Continued on LIC-809 C.