Facility Evaluation Report

On 7/11/202 at 09:45am, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced annual 1-year required inspection. LPA met with Dawlt Sevoum, Caregiver and explained the purpose of the visit. Caregiver Debelo Fufa arrived at 10:30am, House Manager , Deberitu Mekonnen, arrived at 11:20am. Administrator certificate #6006628735 expires 11/24/2023. Facility's fire clearance is for six (6) ambulatory and one (1) non-ambulatory client.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area, and back yard. The facility consists of four (4) total bedrooms and three (3) bathrooms. One (1) bedroom is occupied by staff. All indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for clients is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 95.1 degrees Fahrenheit. Hand washing poster, paper towel, and soap observed at all hand washing stations. The supply of extra hygiene was available for residents. There is a minimum of 7-day non-perishables and 2-day perishables foods.

Smoke detectors/carbon monoxide were in operating condition during visit. Emergency disaster plan updated 10/1/2023. Fire extinguisher was last services on 1/09/2024. Last fire drill conducted 3/26/2024. First aid kit was observed to be complete.