Facility Evaluation Report

Licensee Program Analyst Jason Lund arrived unannounced to conduct an one year required inspection. LPA Lund met with care staff Hannah Bugas and explained the reason for the visit staff called Administrator Maria Payla who could not make the visit today. Administrator Maria Payla gave permission for care staff Hannah Bugas to sign the required paperwork. Census 3

LPA Lund & care staff Hannah Bugas toured/inspected the facility including common areas, resident bathrooms, kitchen, dining room, laundry, storage, and outside yard area. The facility is clean and in good repair and no odors were detected in areas toured. No hazards were noted in courtyard areas, hallways, doorways, etc. No equipment was stored in public areas. Fixtures and furniture all appear to be in good condition. Cleaning solutions are stored in the closet. Handrails are present in all shower and toilet areas, are secured. Room temperature was comfortable in facility. Facility has supply of bedding and towels. Furniture is appropriate in bedrooms for residents. There is adequate closet/drawer space available. There are plenty of bathrooms for number of residents. Non-skid mats will be purchased for the two showers. Kitchen is clean, well-supplied with equipment. Cooler/freezer appear to be at appropriate temperatures. First aid supplies available in several locations. Laundry equipment present, working telephone, emergency lighting. Medication was locked and secure. LPA Lund observed the fire extinguisher (08/11/2025) and carbon monoxide detector to be in compliance. LPA Lund reviewed two staff & two resident files and are in compliance.

No deficiencies were observed at this time. Exit interview conducted and report left.