Facility Evaluation Report

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced Annual Required visit and inspection of the facility. The facility is a one-story Residential Care Facility for the Elderly (RCFE) licensed for six (6) non-ambulatory residents. The facility has a dementia waiver; a hospice waiver for six residents; and a fire clearance for one bedridden resident.

At the time of arrival, there were five (5) residents in care with one caregiver and two administrators on duty. Administrators Johnna Udden and Co-Administrator Helen Busch participated in the inspection.

Currently, there are two residents on hospice residing in the facility.

LPA inspected the one-story facility for fire safety, personal accommodations, and food service and the following was noted: LPA observed the required posting of the complaint poster and Resident’s Rights.

The physical environment was checked for cleanliness and condition. Walls, windows, ceilings, doors, floors, and floor coverings were checked. The facility was seen to be in good repair inside and outside. One fire extinguisher was inspected and last serviced on 4/7/2026. The carbon monoxide detector and smoke alarms are hard-wired and in good working order. Additionally, the facility has one fire pull alarm.

The kitchen area was sufficiently stocked with two-day perishables and seven days of non-perishables. Snacks and beverages are readily available. Frozen foods are properly wrapped and stored appropriately. LPA observed the kitchen cabinets, refrigerator, stove, and counters are clean.

Medications, First Aid kit, and additional first aid supplies are kept in a locked cabinet in the garage. First aid kit was observed to be complete.

Knives and sharps are kept in a locked box in a kitchen drawer.