Facility Evaluation Report

Licensing Program Analyst, LPA, Noel Wolf Petersen and Licensing Program Manager, LPM, Liza King arrived unannounced at 10:45am to conduct an annual inspection. Pedrose Home Care, is a 6 capacity facility for 5 nonamb and 1 bedridden. There is 3 resident on hospice, 2 residents who are bedridden and 3 residents with dementia. Facility is observed to have 2 bedridden clients, operating outside the license and beyond the buildings fire clearance, citations issued on following d-page.

Physical Plant inspection was conducted including but not limited to kitchen, common areas, bedrooms, bathrooms, storage areas, staff room, exteriors, and evacuation routes. facilility is clean and traffic areas are unobstructed and well lit.

Kitchen, has adequate food supply 2 days perishable, 7 days non perishable. Sharps, Medications, are stored locked.

common areas and exterior have space for activities and free of trip hazards.

Evacuation route gate is in good repair, swings freely and latches closed.

bathrooms have functioning hardware, water is delivered within range 105-120*F.

Bedrooms have required furniture and furnishings, mattresses are have rubber encasements.