Facility Evaluation Report

LPA Albert Johnson arrived unannounced for a case management visit. To follow-up on clarification with the Licensee if there has been any progress in the change of ownership since the last request on 02/09/2022.

The following items are still outstanding:

A1. Application for Facility License (LIC 200)

-Check box “B” under the section titled “Business Experience” and resubmit complete form for Rick Jenson.

-Check box “B and C” under the section titled “Business Experience” and resubmit complete form for Brian Uhlir.

-Submit complete LIC 215 for Steve Kregel.

A9. Financial Information Release and Verification (LIC 404)

-Please provide a copy of the most recent bank statement for Northstar Senior Living Inc. showing liquid assets 1x the amount of Line 37 on the Monthly Operating Statement (LIC 401).