Facility Evaluation Report

On 3/11/2026 at 10:00am Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a required Annual Inspection. Upon arrival LPA was greeted by the House Manager Millicent Dimson who granted access to the facility. LPA introduced herself by showing her badge and explained the reason for the visit. LPA Khurshudyan reviewed the required postings on a wall throughout the facility.

The inspection tool was used to complete today's visit.

At 12:15pm LPA with the help of the House Manager, began a physical plant tour of the facility and the following was observed: This is a single-story building with four (04) bedrooms, two and half (2.5) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for four (4) ambulatory clients, of which two (2) may be non-ambulatory in bedroom #1. Facility is operating level 4G/5 clients.

Kitchen: LPA observed a seven-day supply of non-perishable food and a two-day supply of perishable food properly stored and labeled. Facility stores knives and sharps inside kitchen cabinet that is always locked and under supervision. Emergency supply of food / water was stored inside the pantry. LPA observed fully charged one (1) fire extinguisher located in the kitchen by the refrigerator. Fire extinguisher service date is 12/21/2025. A weekly menu was also available.

Common Areas: These include living and dining areas . LPA observed dining, living areas clean and clear of clutter. Furniture is generally new and in a good repair. Dining and living room furniture sits at the capacity of the facility. Walls, floors, windows, screens, and blinds were clean and in good repair. At 12:20pm, LPA measured the room temperature to be 69 degrees Fahrenheit. There is a linen closet in the hallway with an adequate supply of fresh linens ready to use. No obstructions or tripping hazards throughout the facility. Facility has landline, LPA checked it was operational. Continue on LIC809-C