Facility Evaluation Report

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to conduct the quarterly visit for November. LPA met with administrator Kathleen Quiaot and explained the purpose of the visit. Willow care home is licensed as a 6 capacity adult residential facility with a current census of 4. no residents have restricted conditons.

LPA conducted a physical plant inspection including but not limited to the kitchen, bathroom, bedroom, common areas, exteriors, and evacuation routes. facility is clean, traffic areas are well lit and unobstructed. kitchen has adequate food supply for 2 days perishable, 7 days non-perishable, there is lockable storage for toxics and sharps. Bathroom has functional hardware, water is delivered between 105-120*F. bedrooms have required furniture and furnishings, including mattress encasements. exteriors and common areas have space for activities. the evacuation route gate swings freely and latches closed. Required posters are present. The fire extinguisher is dated 4/6/25, the first aid kit is complete.

Body/bag check log is together, filled out completely. The LPA interviewed the three of four residents, they remembered their bags being checked, and giving permission for the checks.Occasionally, residents do not give permission immediately and the staff wait 15ish minutes and ask again and are better received.

No staff records or client records were checked at this time, no changes to staff or client roster have occurred since August at least.

A copy of the report was read and given to the administrator. Licensee is compliant with the increased monitoring at this time. No citations were issued at this time. exit interview was conduct.