Facility Evaluation Report

On 8/17/22 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1-year annual visit. LPA Jensen met with care giver and explained the purpose of today's visit.

The facility is a single story facility that has a gated front yard. There is a single designated entrance with COVID signs posted outside. LPA was greeted by care staff and screened, including a temperature check upon arrival. LPA Jensen toured the facility including but not limited to grounds, kitchen, 3 bedrooms, 1 staff room, dining room, living room, 2 bathrooms, garage and laundry room. The facility was sanitary and equipped with adequate lighting.

The facility sketch was posted and accurately reflects the premises. The temperature was 74 degrees and is within the required regulatory range of 68-85 degrees. There were 2 first aid kits observed that were complete. Emergency lighting was on hand. The hallways were equipped with night lights. A 30 day supply of personal protective equipment was observed. Carbon monoxide detectors were tested and observed to be in working order. The fire extinguisher was last serviced in March of 2022 and is in compliance.

The kitchen was observed to have at least two day of perishable food and 7 days of non-perishable food. There was fresh fruit observed accessible to residents in care. Knives were observed to be locked and inaccessible to residents in care. Toxins and cleaning supplies were observed to be locked and inaccessible to residents in care. 3 kitchen cabinets next to dining room, where utensils are stored, were observed to be broken and missing knobs.

The water temperature measured 118 degrees which is within the regulatory range of 105-120 degrees.

The facility has an adequate supply of linens. The resident bedrooms were observed to be equipped with all necessary furniture. The window screens were in good repair. The laundry room contained a washer and dryer in working order and had toxins locked and inaccessible to residents.