Facility Evaluation Report

02/18/2025 09:45 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with administrator DarrIck Ericksen ( cert. 7001936735 exp 04/09/2025) and explained the purpose of the visit.

LPA Knight and the administrator toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to four (4) resident rooms, common areas, two (2) bathrooms, kitchen, storage areas and back yard. Staff and resident files were reviewed.

Common area, kitchen, and bathrooms were clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food. Medication is locked in a cabinet.

First aid kit fully stocked and ready for emergency use. Fire extinguishers fully charged and inspected. Smoke detectors are all operational. All employees requiring background checks are cleared.

No pools/bodies of water are on premises. The facility has been conducting emergency evacuation drills every quarterly.

A deficiency is being cited as a result of today’s inspection and is documented on the attached LIC809-D. One client room has a leaky window that needs to be caulked and there are stained ceiling tiles indicating that a possible roof leak occurred at some point since the last annual inspection.

Exit interview conducted and copy of report was provided to administrator DarrIck Ericksen