Facility Evaluation Report

Licensing Program Analyst (LPA) Hiratsuka visited the facility to do an annual visit. LPA met with licensee Paul Hase. The residents were at their day programs during this visit.

This facility has a fire clearance for three ambulatory residents only. LPA toured the facility including common areas, kitchen, dining, bedrooms, bathrooms, hallways, sun room, yard, laundry. The facility is very clean and in good condition. Bedrooms are appropriately furnished as per regulation. Food supplies are adequate to meet the requirement of 2 days perishable and 7 days non-perishable supplies. Food is appropriately stored. Smoke detectors and carbon monoxide detector installed. Fire extinguishers present and charged. LPA reviewed one staff file and one resident file.

At this time, it appears that the facility is in substantial compliance with the regulations. No deficiencies were cited at this time. Exit interview conducted.