Facility Evaluation Report

On 09/27/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual

Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with House lead Evelyn Morgan. Administrator Rosalind Ward was called and arrived during inspection. Upon arrival LPA observed two clients leaving to day program. One client was present upon LPA arrival and left to day program during inspection. Area Director Troy Rice arrived later during inspection.

The facility was observed to be at a comfortable temperature at 74 degrees F, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Fire extinguisher was observed with a service date of: 06/26/23. Fire drill last completed on 09/21/23. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -14 degrees F and refrigerator temperature was maintained at 30 degrees F. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms were toured and observed to be operational. Hot water temperature was tested 96.1 degrees F. in bathroom 1 and range between 105 and

106.1 degrees F. in bathroom 2 and 105.5 degrees F in bathroom 3.

Medications were checked and observed kept locked in hallway shelf. Clients’ MARS was reviewed. Cleaning chemicals was observed stored and locked in the garage cabinet. Carbon monoxide and smoke detectors were tested and observed to be operational. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients and free of debris. All clients’ file reviewed to have update Emergency contacts, Admission agreement, IPP, and physician report. LPA reviewed three staff files to have current First Aid/CPR, Personnel Record, Criminal record Statement, and Health Screening. Staff are fingerprinted cleared and associated to facility.

No deficiency was cited during inspection. Exit Interview conducted. LPA received copy of current Administrator certificate, Lic 308, Lic 309, Lic 400, Lic 402, Lic 500, Lic 610D, Lic 9020. A copy of this report was provided to Administrator, whose signature on this form confirms receipt of these report.