Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection, and met with licensee Thelma Blanchard (LCN) and Administrator (ADM) Michelle Bayquen.

2 staff and 2 residents were observed in the facility. LCN stated the facility is a RCFE with MI residents.

2 resident file and 3 staff files were reviewed.

LPA toured the facility inside out with ADM. Dinning room, kitchen and family room were inspected. 4 resident bedrooms and 2 restrooms were inspected. 1 office and 1 staff room were observed in the facility. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet was observed locked. Knives closet, and dish cleaning product closet were observed unlocked. One resident bedroom's screen window was observed missing. Litters were observed on the floors of dining room, kitchen and resident bedrooms. No non-skid mat was observed in the bathrooms. First aid box was observed in the facility. Room temperature was at 70 degree F and hot water temperature was at 119 degree F. Flash lights were observed out of battery. No night light was observed in the hall way, ADM stated the light in the hallway was turned at night. Two residents confirmed the light of the hallway was turned on at night.

Fire extinguisher was serviced on 10/30/2023. The facility was equipped with smoke and carbon monoxide detectors. Carbon monoxide detector was found out of battery. Front yard and backyard were inspected. Three matters were observed at side of the building to block the walkways. LCN stated the last the facility conducted the emergency and fire drill was 4/16/24.

Citations were noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of this report was provided to ADM