Facility Evaluation Report

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Caregiver. Administrator Kelly Eriksen arrived later. Facility currently has two [2] residents on hospice which is allowable per the facility's Hospice Waiver for two [2]. One resident is bedridden and resides in bedroom with bedridden fire clearance per STD850.

At approximately 9:30am LPA and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled. Kitchen cabinet containing cleaning supplies and sharp knives was locked.

All bedrooms were equipped with lighting/lamp, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperature in sink(s) accessible to residents in care measured at 112 and 110.5 degrees F, respectively which is within the allowable range of 105 to 120 degrees F.

Fire extinguishers were last inspected 1/29/2024. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Exit doors have an auditory alert system that was functional at time of inspection. Facility’s last quarterly disaster drill was conducted on 1/12/2024. Facility has a backup generator for use during a power outage.

At approximately 11:35am LPA conducted a review of six [6] out of six [6] resident files. All required documents present.