Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with 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 5 resident rooms, common living areas, activity room, dining room, kitchen and storage. 5 Out of 5 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 sinks ranged from 116.0 - 116.2 degrees F.

Fire extinguisher was observed and inspected on 05/06/2026. Facility smoke detectors were inspected by third party vendor. The last disaster drills were conducted on 06/12/2026 and 06/19/2026. LPA Rai observed a complete first aid kit at the facility. LPA Rai reviewed facility records for 6 staff and 6 residents. LPA Rai reviewed resident medications and central stored medication records.

During today's visit, LPA Rai discussed an Incident Report the Department received regarding a resident(R1) to resident (R2) altercations occurring in the Memory Care unit. LPA Rai interviewed 5 residents and 6 staff.