Facility Evaluation Report

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 03/10/2022. LPA met with facility administrator Marlene Elliott (Admin).

LPA toured the facility, including living room, kitchen, dining room, 5 bedrooms, 2 bathrooms, laundry room, and back yard. All staff members observed to be wearing masks. Admin confirmed that all staff and residents have been vaccinated.

Facility Mitigation plan has already been submitted. No prohibited items noted in resident rooms. All emergency exits noted to be clear of obstruction. All rooms in facility noted to be clean and well maintained. Hand sanitizers, soap, and paper supplies were observed to be available. At least 2 days' supply of perishable food and at least 1 week's supply of non-perishable food was observed on the premises. Fire extinguishers observed to be inspected in June 2021. Smoke detectors tested and observed to be fully operational. Facility temeprature observed to be 65 *F. Water temperature observed to be 119 *F.

Facility observed to have designated entry point. Staff took LPA's temperature and screened for symptoms. Facility did not have a thirty day supply of PPE on the premises. Hand washing signs observed in all bathrooms. Social distancing signs observed to be posted in all public areas. Both bathrooms observed to have had lidded trash cans.

No deficiencies cited during today's visit. Advisory note issued. This report was reviewed with facility Administrator Marlene Elliott and a copy of the signed report was provided.