Facility Evaluation Report

L icensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Assistant Executive Director, Mark Nelson and Administrator, Rosalie Zbasnik/Hulog and stated the purpose of today's visit.

During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents.

LPA Rai toured the facility to include at random 10 resident rooms. 10 Out of 10 resident bedrooms had available bedding, drawers, and functioning lights. The facility bathroom had available soap, paper towels, and trash cans with lids. The hot water temperature in the bathroom sink ranged from 109.9 - 118.1 degrees F.

Facility smoke detectors and sprinklers were in working condition and inspected by a third party vendor on 4/23/2024 and 5/8/2025. The last disaster drills were conducted on 7/4/2025 and 7/22/2025.

LPA Rai reviewed facility records for 10 staff and 10 residents. LPA Rai reviewed resident medications and central stored medication records.