Facility Evaluation Report

On 01/10/2024, Licensing Program Analysts (LPA) L. Salazar conducted an announced Prelicensing and Component III inspection. LPA introduced self, stated the purpose of the visit, and was granted entry into the facility. LPA met with Licensee, Tishie Marie Froshour.

The facility is 5 bedroom and 3 bathroom home. Fire clearance was granted for 6 Non-Ambulatory for total of 6 capacity. There are 2 residents in care at this time. present during this inspection. Facility temperature is set to 73 degrees .

LPA toured the facility with Licensee. Common areas were furnished and had adequate seating and lighting available. Bedrooms were observed to have required furnishings. Hot water measured at 119 degrees F in client bathroom. LPA observed an extra supply of bed linens and personal hygiene products. Kitchen was toured and observed to have dishes, plate, and utensils. LPAs observed a 2 day supply of perishable foods and a 7 day supply of non-perishable foods. Knives were observed to be locked and secure in a the metal box that is locked in the kitchen cabinet.

Cleaning supplies and chemicals were observed to be in a locked cabinet in laundry room. Medications were kept locked and inaccessible to residents in care. First aid kit was observed and contained all required items. A fire extinguisher was observed and has a service date of 06/23/2023. Smoke detectors and carbon monoxide detectors were observed to be operational during this inspection.

Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching. Resident records were reviewed. LPAs observed resident Admission Agreements and Physician Reports. Staff records were reviewed. 5 out of 7 personnel records did not have a criminal record clearance. LPA confirmed in LIS that staff are cleared and associated to the facility. Last fire drill conducted on 01/03/2024.