Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi arrived to this facility today to conduct a One (1) year Required inspection of this facility with emphasis on infection control practices and procedures. Upon arrival, LPA met with Administrator Loretta Louise Tiede and explained the reason for the visit.

Facility has (6) resident bedrooms and (3) bathrooms currently occupying (6) residents. (1) bedroom is designated for the staff. Fire extinguishers were observed fully charged and last serviced in October of 2022. Carbon / Smoke detectors were tested and observed to be operation during the time of the visit. All door alarms for exit ways were observed to functional during the visit as well.

At approx. 11:00am, LPA toured the facility with Administrator The kitchen appeared to be relatively clean at this time and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects were observed stored in the top drawer to the left of the sink.

Dining room furniture appeared to be relatively clean and functional at the time of the visit. At approximately 11:15am, LPA observed (4) residents having lunch at the dining table and (2) residents watching television in the living room. The living room was checked for cleanliness and furniture was checked for functionality during time of visit. Furniture appeared to be relatively clean and functional at this time.

The resident bedrooms were properly furnished with a bed, night stand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Extra linen are kept in a cabinet in the hallway nearest bedroom #1. LPA observed a sufficient supply of linen and personal hygiene supplies stored at this location as well.