Facility Evaluation Report

Licensing Program Analyst (LPA) Hansen conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility. LPA was welcomed by staff who directed LPA to sanitize hands, screen for symptoms, and sign-in on visitor sheet. LPA met with Licensee Eric Moessing. There are 15 residents in care at the facility with 3 on Hospice and 6 with dementia.

Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility began the process today of having new flooring put in the front room and hallways which will be complete tomorrow. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. There was a sufficient amount of perishable and non-perishable foods in the kitchen and in locked storage room off of the kitchen . Extra hygiene products and linens were available and required bathmats and grab bars were observed. Water temperature in resident's bathrooms measured 114.4degrees F to 118.4 degrees F which is within acceptable range of 105 to 120 degrees F. Cleaning products and other toxins are located in locked cabinet under kitchen sink and in locked laundry room. Knives are kept in a locked cabinet in the kitchen inaccessible to residents. Medications are centrally stored and locked in kitchen cabinet.

Fire extinguisher was last inspected 8/18/2021 but is fully charged. Facility's last fire alarm service inspection was conducted 11/2021. Last Disaster Drill was conducted on 7/26/2022. Auditory alarms were functional at the time of visit.

Facility has submitted a mitigation program plan that has been approved along with Infection Control Plan. Posters have been placed at facility. Entrance has small table with hand sanitizer and other items designated for visitors and staff before coming into work. Facility has PPE supply stored in spare hallway closet. Facility has a 30-day supply of medication for residents. All staff had masks on during this visit.