Routine inspection·January 24, 2024

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection, and met with Administrator (ADM) Justin Ladwig . License, Personal Rights posters, and Administrator Certificate were observed at entrance. LPA observed 3 staff and 5 residents in the facility. LPA reviewed 3 residents files and 3 staff files. LPA toured the facility with ADM inside and out. LPA inspected living room, kitchen, dining area, 2 reading rooms, and laundry room. There are 6 single rooms for residents, and one staff live-in room in facility. 3 bathrooms were inspected. Grabs and non-skid mats were observed in the bathrooms. Two days perishable foods and seven nonperishable foods were observed sufficient. Room temperature was observed at 72 degree F. Hot water was observed at 119 degree F. Medication cabinet, Knife closet, and cleaning products closet were observed locked. LPA checked the call bell in resident room and the staff responded in 2 minutes. First Aid box, flash lights were observed in the facility. Front yard and back yard were inspected. No obstruction was observed to block the walkway. ADM stated the last date that the facility conducted the emergency drill was 1/12/2024. Deficiency noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of this report was provided to ADM.