Pre-licensing visit·September 14, 2021

Licensing Program Analyst (LPA) Ryker Heberle conducted an unannounced pre-licensing inspection today. LPA met with Administrators (ADMs) Irish & Justin Ladwig. At around 2:01pm, LPA toured the facility inside and out. Including living room, dining room, kitchen, family room, 5 bedrooms, 3 bathrooms, utility/laundry room, and garage. A screening station was observed by the entry door for anyone coming in the facility. Facility staff properly screened LPA before entering the facility. The facility is equipped with connected smoke detectors. The smoke detector located in the dining room was tested and observed working. All fire/carbon monoxide detectors observed to be connected. Fire extinguisher was observed in the dining room and had been last serviced in August of 2021. The kitchen, dining, living room, and family room were observed in good repair. Resident and personnel files observed to contain all necessary documentation, including Appraisal Needs and Services Plans, Physician's Reports, first aid certifications, and criminal background clearances. Resident bedrooms were observed in good repair, furnished, with clean linens and adequate lighting. Screen door in bedroom #5 noted to be damaged. LPA advised ADMs to fix screen door. Bathrooms were observed clean and equipped with grab bars and non-skid mats. The water temperature was measured at 116 degrees F in facility bathroom. Centrally stored medication cabinet was observed. 2 days supply of perishable and 1 weeks supply of nonperishable food observed. A complete first aid kit was inspected. All outdoor and indoor passageways were observed clear and free of obstruction. No bodies of water observed. Component III orientation was waived due to licensee's prior experience. Based on today's inspection, the physical plant is recommended for licensure pending the completion of all application documents with the Central Applications Bureau (CAB). Exit interview conducted with and copy of report provided to Administrator Irish & Justin Ladwig.