Facility Evaluation Report

On 8/18/2022 at 01:00PM, Licensing Program Analyst (LPA) L. Hall arrived announced to conduct Pre-licensing inspection. LPA met with Mike Nubla, Administrator and explained the purpose of the visit.

LPA inspected the facility inside and out including but not limited to the bedrooms, bathrooms, common living areas, kitchen, garage and back yard. The facility has a total of five (5) bedrooms and two (2) bathrooms There is sufficient lighting around the facility. Clients rooms are equipped with the beds, chairs, and lighting. Clients rooms have proper bedding and linens. Passageways and hallways are free of obstruction. Hot water temperature is measured at 124.4 degrees Fahrenheit. Fire extinguisher last serviced on 5/26/2022. Smoke detectors/carbon Monoxide detector are equipped around the facility.

Licensing Program Manager (LPM), H. Humpal gave approval to waive the Comp III.

No Issues were noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided.