Facility Evaluation Report

Licensing Program Analysts (LPA) Graham Gunby and Cheyenne Ratajczak arrived on Thursday November 14, 2024 to conduct an announced prelicensing visit.

The Compliance and Regulatory Enforcement Tool was used during today's inspection. All files contained the required paperwork. This facility has a fire clearance for 6 (six) nonambulatory, of which 2 (two) can be on hospice and 1 (one) bedridden. Facility has all required postings in the hallway.

LPAs toured the facility with the administrator. The following areas were inspected for compliance: kitchen, backyard, resident bedrooms, bathrooms, and common areas. Facility has current fire extinguisher and a full first aid kit. Medications will be kept locked in a cabinet in the hallway. Cleaning chemicals and knives/sharps are kept locked and inaccessible to residents.

Component III has been completed at this time.

The facility appears to be in substantial compliance and ready for licensure. The license will be granted upon completion of a final review and approval from the Licensing Program Manager and the Central Applications Bureau. An exit interview was conducted with Administrator and a copy of this report will be left at the facility.