Facility Evaluation Report

Unannounced Annual visit made out to this facility on 04/20/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility house manager, Mandy Whitthar, at this time. A brief interview was conducted with the facility house manager at this time. This LPA requested that she go ahead and contact the facility designated Administrator, Stacy Wycoff, to inform her that CCL was present at this time. The facility designated Administrator arrived later to this facility while this LPA was conducting this visit.

It was learned that this facility was vendorized to be able to accept and retain up to (6) Level 3 residents at any given time. This facility was licensed to serve up to (6) Ambulatory only residents at any given time. Current census was 6 residents, of which (6) of them, were out of the facility at their respectable day programs at this time.

A tour of the facility kitchen area was conducted. Drawers and cabinets were opened and the items enclosed were reviewed at this time. Drawers housing knives and sharps were observed to be locked and made inaccessible to the residents at this time.

Cleaning agents, bleach, and other supplies which were stored in a closet and were observed to be locked and made inaccessible to the residents at this time.

A review of the facility food supply was conducted. A review of the facility's 2-day perishable foods and 7-day nonperishable foods was conducted to make sure that there were sufficient quantities on hand at all times.

Medication cabinet, located in the kitchen cabinet, was reviewed. Policies and procedures involving handling, dispensing, and documentation of the resident medications were discussed with the facility designated house manager at this time. A review of the facility Medication Administration Record and dispensing log was conducted.