Facility Evaluation Report

Licensing Program Analyst (LPA) Joe Katrdzhyan conducted a site visit for the Required - 1 Year inspection. Upon arriving at the facility, LPA met with Staff / Nellie Holmes and was later joined by the Administrator / Swarna Amarsinghe who assisted with the visit. The facility is licensed to serve for a capacity of forty six (46) clients ages 18-59, Ambulatory only. The Licensee has submitted a request for a capacity increase from forty six (46) clients ages 18-59 to forty eight (48) clients ages 18-59 , Ambulatory only. A fire clearance increase was granted by Inspector Jim Groff. The capacity increase is currently pending through CCL. During today's visit, LPA used the infection control domain to complete the Required - 1 Year inspection. Also, the physical plant was toured, medications and food supplies reviewed.

The facility is operating within the scope of it's license. The facility consists of 6 separate buildings.

Building 1 includes a living room, dining room, office, kitchen, six bedrooms (shared) and two bathrooms.

Building 2 includes 2 bedrooms (shared) and 2 bathrooms. There is one vacancy in room #4.

Building 3 includes 1 bedroom (shared), 1 bathroom, laundry room and storage room.

Building 4 includes 2 bedrooms and 1 bathroom.

Building 5/Office includes 10 bedrooms (shared) and 5 bathrooms. There is one vacancy in room #12.

Building 6/Trailer includes 3 bedrooms, 2 bathrooms, a living room/lounge and a kitchen (without a stove). No cooking is done in the trailer.

LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. LPA toured a random selection of client rooms. Client rooms were furnished appropriately. The bathrooms were observed to be clean and operational. The hot water temperature was tested throughout the facility. The outdoor patio area was enclosed. There is no pool or other large bodies of water. The back yard is free of debris /hazards and outdoor passageways are free of obstruction. The trash cans have covered lids.

(Please see LIC 809C for additional information)