Deficiencies per Year
4
3
2
1
0
Inspection Report
Original Licensing
Capacity: 20
Deficiencies: 0
Sep 12, 2025
Visit Reason
The inspection was conducted as part of the original licensing study for Forest Glen Assisted Living to determine compliance with applicable licensing statutes and administrative rules.
Findings
The facility was found to be in substantial compliance with licensing requirements, with no rule or statutory violations noted. The home is a 20-bed adult foster care large group home, physically described as a single-story building with appropriate safety features and accommodations for residents.
Report Facts
Licensed capacity: 20
Resident beds: 20
Staff to resident ratio: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shannan Van Houten | Licensee Designee | Appointed as licensee designee for the facility. |
| Kelsey Kline | Administrator | Appointed as administrator and responsible for day-to-day operations; holds a bachelor's degree and has relevant experience. |
| Nile Khabeiry | Licensing Consultant | Conducted the licensing study and recommended issuance of the temporary license. |
| Russell B. Misiak | Area Manager | Approved the licensing report. |
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