Facility Evaluation Report

At 10:50 AM on 8/19/2025, Licensing Program Analyst (LPA) Triel Ellen Lindstrom arrived at the facility unannounced to conduct a required annual inspection. The LPA was greeted by the Administrator. The LPA identified herself, explained the purpose of the visit, and an interview followed. The Administrator accompanied the LPA on a tour of the facility.

This facility is licensed to serve fourteen ambulatory residents. It is a six-bedroom, 5-bathroom house located in a residential area. The census was fourteen residents; none were home at the time of this inspection. There was two staff on duty when the LPA arrived, both of whom have criminal background clearances.

The LPA toured the inside of the house, including the bedrooms, bathrooms, kitchen, two dining rooms, two living rooms, 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 in the common areas.

The LPA inspected the fire alarm and detection system. There were smoke alarms in every bedroom and three in common areas. There were four fire alarm pull stations that were connected to an alarm box in the staff office. The Administrator tested the alarm system, and it was in working order. The Administrator tested the carbon monoxide detector in the hallway and it was in working order. There were four fire extinguishers located throughout the house. The fire extinguishers were last serviced on 11/19/2024 by Cisco Fire. The LPA observed documentation of monthly disaster drills.