Routine inspection·July 12, 2021

Licensing Program Analyst (LPA) Jim August conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into the facility by Administrator Fredric Robart and explained the reason for the visit. LPA August toured the facility. There are six clients residing in the facility and no active covid-19 cases. LPA observed six clients on site. All clients appeared clean and well taken care of. LPA observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed had ample soap/ sanitizer and appeared clean. Client bedrooms appeared clean and sanitary and had all required components. Facility is taking client's temperatures daily and documenting results. LPA observed the emergency disaster, LIC808 Covid mitigation plan and evacuation plans. Facility has back-up emergency food and water supply as well as PPE supplies. No citations noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.