Routine inspection·September 28, 2023

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit and met with Administrator (ADM) Irish Ladwig. LPA checked 5 resident files and 4 staff files. License, personal rights, Administrator Certificate and visitor hours posters were observed at the main entrance. LPA toured the facility inside out with ADM. LPA inspected living room, kitchen, dinning area, restrooms, laundry room and garage. The facility has 6 resident rooms, 3 restrooms, 2 staff rooms. A room was observed in the garage. ADM stated that is a storage room. Medication closet, knives closet, and cleaning product closet were observed locked. Non-skid mats and handle bars were observed in bathrooms. Room temperature was observed at 76 degree F, and hot water temperature was observed at 110 degree F. Refrigerator temperature was measured at 35 degree F, freezer temperature was measured at -10 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. The facility is equipped with fire alarm and smoke and carbon monoxide detectors. ADM tested the smoke and carbon monoxide detectors, and they were working fine. The fire extinguishers were observed on service on 8/15/2023. LPA inspected the backyard, there was no obstruction to block the walkway. LPA discussed Infection Control Plan with ADM. ADM stated ADM will update it and send to LPA. A deficiency was noted today. LIC809-D was attached. Exit interview was conducted with ADM. The re[ort was provided to ADM for signature. A copy of the reports were provided to ADM.