Facility Evaluation Report

On 7/22/2022 at 12:45AM, Licensing Program Analyst (LPA) G. Luk conducted a Pre-licensing Inspection. LPA met with Program Director, Alexander Vandenbelt.

The facility's fire clearance was approved for 6 ambulatory clients.

LPA toured facility including but not limited to client's bedrooms, bathrooms, living room, kitchen, garage, and outdoor area. LPA observed lighting in all rooms. LPA observed facility had a 7-day of nonperishable and 2-day of perishable food supplies. Facility had combination smoke and carbon monoxide detectors and observed in operating conditions. First aid kit was complete. Medications were locked in the medication room.

The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB):

1. Each client did not have a night stand and a chair in the room.

2. Hot water was measured at 125 degrees F.

3. Outdoor pathways were uneven in the backyard. Bricks were uneven and some trims on the pathways were lifting.

4. Three clients did not have TB test and two clients did not have medical assessment on file. Medical assessment were signed by nurse practitioner instead of a doctor.

5. Personnel records were not maintained on site. Facility does not have a waiver to keep personnel records off site.