Facility Evaluation Report

On 5/26/23 at approximately 9:30am Licensing Program Analyst (LPA) Maja Jensen arrived unannounced to conduct a required 1 year annual inspection. LPA Jensen met with Licensee Elizabeth Abesa and explained the purpose of today's visit. Elizabeth holds current Administrator certificate # 6010093740 good through 10/26/23.

LPA Jensen toured the grounds and interior of the facility. The grounds were observed to be maintained and all paths were clear of obstruction. Window screens were determined to be in good repair. There is outdoor furniture and shaded areas available for outdoor activities. LPA Jensen observed the interior of the facility to be sanitary and free of odor. The facility maintains adequate furnishings and lighting. Each bedroom was observed to have a dresser, night stand, lamp and chair. The thermostat was set at 68 degrees for the residents. The water temperature was measured at 110.9 degrees and is within the required range of 105-120 degrees. The bathrooms are equipped with grab bars at the toilet and in the shower. The bathrooms are equipped with paper towel dispensers for single use. The waste containers were observed to have tight fitting lids. The facility kitchen was inspected. The facility maintains 2 day supply of perishable food and 7 day supply of non-perishable food. Lunch preparation and service was observed. The lunch menu consisted of fish, scalloped potatoes, salad and juice. LPA Jensen observed fresh fruit and vegetables on hand. An adequate supply of linen is kept on site. Bedding was observed to be clean.

Medication was locked and inaccessible to residents in care. PRN medication is documented appropriately for effectiveness. Medication was observed to be pre-poured for the next two days. LPA Jensen conducted a count of 1 resident's medication and determined the count to be accurate. The facility maintains a first aid kit that was determined to be complete with scissors, tweezers, thermometer, manual and various wound dressings. The fire alarm and carbon monoxide detector were tested and determined to be in good working order. The facility maintains emergency lighting and supplies. The fire extinguisher was last serviced in February of 2023 and is in compliance. Continued on LIC 809C....