Routine inspection·March 25, 2026

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to conduct an annual inspection. LPA met with Administrator/licensee Georgia Wilcomb and explained the purpose of the visit. The Physical inspection included but was not limited to the bedrooms, bathrooms, kitchen, common areas, exterior, evacuation route. Facility is clean on the interior, traffic areas are unobstructed and well lit. Kitchen had adequate food storage and food for 15 people, at least 2 days perishable and 7 days non perishable food was observed. Kitchen had adequate lockable storage for sharps, toxics, and Medication. The Bathrooms had hardware in good repair, the water temperature was measured 105-120*F. The bedrooms had adequate furniture and furnishings, to include mattress encasements. Common areas and exteriors have adequate space for activities. Exterior has some upkeep needed, there is high grass in the back, trash in the form of 7/11 cups, fruits on the ground attracting flies. 5 client files were reviewed, to include health screenings, signed admission agreements, addendums to the admission agreement, needs and services plans, functional capability assessment. there were some changes to thier health. (for the better) where a different set of needs and services might apply to them. LPA gave guidance to the facility to get new 602 medical assessments and redo the needs and services plans for clients who have changes to their health. 5 staff files were reviewed, to include health screenings, finger printing clearance, first aid/cpr, and continuing/initial training. files are present and up to date. 4 clients were interviewed, 1 staff was interviewed. Continued on C page. Administrator records were reviewed including but not limited to the control of the property(living trust), infection control plan, and required facility posters to include: facility sketch with evacuation routes, ombudsman/lpa contact information, personal rights, employee rights, and facility license with administrator certificate. files are present and up to date. LIC610d/e (evacuation emergency form)should be sent in to the LPA if theres any changes, if the idea is to use a temporary shelter location that does not have beds, the 610 should detail how bedding arragements will be made. First aid kit has the requiried items, fire extinguisher is dated 2/14/26. there are no bodies of water on the property. Facility is using cameras interior to the facility, the LPA is asking for a a waiver request letter to do cameras inside the facilitiy, public areas only, no bedrooms, no bathrooms, no audio recording. The licesnee should include a updated plan of operation where the camera policy is outlined, and an admission agreement ammendum notifying the residents they are recorded in the public areas of the facility, and a picture of a posted sign for the public notifying/warning them they would be video recorded on the property. If the facility wanted to put up security cameras on the exterior of the facility, the LPA agrees that would be reasonable given the recent thefts, there should similarly be an update to the plan of operation that exterior facing cameras are in use at the facility. No citations associated with this visit. A copy of the report was read and given to the administrator. exit interview was conducted.