Facility Evaluation Report

At 9:45 AM on 8/18/2025, Licensing Program Analyst (LPA) Triel Ellen Lindstrom arrived at the facility unannounced to conduct a required annual inspection. The LPA was greeted by the house manager. The LPA identified herself, explained the purpose of the visit, and asked to meet with the Designated Facility Administrator (DFA). The DFA arrived at the facility at 10:15 AM and an interview followed. The DFA and house manager accompanied the LPA on a tour of the facility.

This facility is licensed to serve four ambulatory residents. The facility is a three bedroom, 2 bathroom house located in a residential area. The census was four consumers, although none were home at the time of this inspection. There was staff on duty.

The LPA toured the inside of the house, including the bedrooms, bathrooms, kitchen, dining room, living room, garage, and laundry room. The entire house was clean, odor-free, and pest-free. The windows and window screens were in good repair. The required documents were posted near the front door and in the living room.

The LPA inspected two smoke detectors, a carbon monoxide detector, and two fire extinguishers. The smoke detectors were in the bedroom hallway and kitchen. Staff tested the smoke detectors and both sounded an alarm. Staff tested the carbon monoxide detector in the kitchen and it sounded an alarm. Both fire extinguishers were last serviced on 9/9/2025 by Jorgensen; one is located in the bedroom hallway and one is in the kitchen. The LPA observed documentation of monthly disaster drills. The LPA Lindstrom that the thermostat was set at 76 degrees Fahrenheit.