Facility Evaluation Report

On 5/7/25 at 10:20 AM, Licensing Program Analysts Noel Wolf Petersen and Michael Bilger arrived unannounced to conduct the annual inspection. They were met by staff and explained the purpose of the visit. This facility has 5 clients, two bedridden, one with oxygen administration, 3 non ambulatory, 2 on hospice care, and a capacity of 8.

LPA's conducted a Physical Plant inspection including but not limited to the resident bedrooms, resident bathrooms, kitchen, hallways, evacuation routes, and the exterior. The required furnishings and furniture are present, the passages are unobstructed and well lit, the facility is clean and in good repair.

The fire extinguisher was last checked 8/20/24, the fire/smoke alarms are in working order, the first aid kit has necessary items, the sharps and toxics and medications are in locked containers and away from the residents in care. The air temperature is 74. The water temperature in the residents bathrooms was measured within the required range of 105-120*f. the required postings of evacuation routes, administrator license, ombudsman poster, client rights poster, and federal workers rights poster. The last fire drill was conducted on 1/23/25, within the quarterly timing.

A review of five (5) client files contained up-to-date needs and services plan, admission agreements, and physicians reports for each client.

A Medication review, conducted with 2 random clients medications and MAR were found to be fully documented and in order