Facility Evaluation Report

On 8/26/2025, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA arrived, introduced self, and allowed entrance by House Manager, Agnes Fanoy. LPA met with Licensee/Administrator, Adonica Vickers to complete facility inspection.

Facility is 4 bedroom, 2 bathroom home. Currently there are four (4) residents in placement. Three (3) residents were present at time of inspection, three observed to be relaxing in the living room watching television and the other was out in the community. Facility tour conducted with Licensee. Facility observed to be clean, well lit, odor free, and a comfortable temperature. All resident bedrooms toured, LPA observed 3 private bedrooms and 1 shared bedroom. Bedrooms observed to have required furnishings. Resident bathrooms toured, fixtures observed to be operational during inspection, water temperature at 116 degrees F. Both living room and dining room observed to have adequate seating for residents. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available for residents. Emergency food supply also observed to be stored separately. All knives are locked and secured in pantry. Medications observed to be locked and secured in hallway closet. LPA medications to have original labels, and to be administered as prescribed.

All cleaning supplies observed to be locked and secured in kitchen cabinet and in locked storage cabinets in garage. Fire extinguisher present with a service date of 5/20/25. Last Fire drill conducted on 5/26/2025 according to facility records. Smoke detectors and carbon monoxide detectors present and observed operational on date of inspection.

Outside of facility toured. All exits open free of obstruction. Pool is surrounded by a wrought iron fence which is locked and inaccessible to residents. No hazards observed.

No deficiencies cited during today's inspection. Exit interview conducted, a copy of this report provided for facility records.