Facility Evaluation Report

On 9/15/2025, Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct the required Annual Inspection. Upon arrival LPA was greeted by the Licensee/ backup Administrator Herbert Amanya, who granted access to the facility. LPA introduced herself by showing her badge and explained the reason for the visit. The facility Administrator Diana Kabazarwe arrived shortly after. LPA Khurshudyan reviewed the required postings on a wall throughout the facility. The inspection tool was used to complete today's visit.

At 11:00am LPA, with the help of the back-up Administrator/Licensee, began a physical plant tour of the facility and the following was observed: This is a single-story building with five (5) bedrooms, two (2) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for four (4) ambulatory clients. Facility is operating level 4G clients.

Kitchen: LPA observed a seven-day supply of non-perishable food, and a two-day supply of perishable food properly stored and labeled. No expired food was observed. Facility stores knives and sharps inside the locked pantry next to the laundry machines. Emergency supply of food / water was stored inside the pantry. Food storage and preparation areas are clean and inaccessible to pests. LPA observed one (1) fire extinguisher located in the kitchen/laundry area with a last service dated 6/13/2025. A weekly menu was also available for clients.

Bedrooms: There are five (5) bedrooms in the facility, of which four (4) are designated for clients use and one (1) bedroom for staff use only. All bedrooms are for private use. LPA observed bedrooms to be properly furnished with beds, linens, night stands, chairs, drawers, closets, and adequate lighting. All bedrooms appeared organized and clean. Continue on LIC809-C