Facility Evaluation Report

On 12/9/25, at 9:00 am, Licensing Program Analyst Noel Wolf Petersen arrived unannounced to conduct a case management related to issues raised during the annual inspection 12/5/2025. Creekside Guest Home is a 6 bed adult residential facility with 3 current clients, serving clients18-59.

At the time of the annual inspection, LPA observed two fire extinguishers out of compliance in regards to thier service date date, 8/14/24. the administrator attempted to go get the extinguishers serviced during the visit, and returned with the extinguishers unserviced and provided the explanation that a special agreement was struck with the fire department to have the extinguishers not serviced until 2027. The LPA asked for a copy of the fire clearance, record review of the 9054 form shows the facility is to maintain the fire extinguisher. LPA returned to follow up with the special agreement 12/9/2025 and finds the extinguishers to be serviced 12/8/25. The period of facility was out of compliance with their fire clearance requiring 2 fire extinguishers for the period of 8/14/25-12/7/25.

Citation issued and appeal rights provided. a copy of the report was read and given to the administrator extit interview was conducted.