Facility Evaluation Report

At 2:00pm, Licensing Program Analyst (LPA) Angela Panushkina conducted an unannounced annual visit to this facility. Upon arrival, LPA rang the bell, but no one answered. LPA contacted the Administrator, Paul Tabachnikov, and explained the reason for the visit. At 2:20pm, Designee Erik Padilla arrived and LPA gained access to the facility.

The Fire Clearance approved for four (4) Ambulatory, where two (2) can be Non-Ambulatory in rooms #1 & #2.

The physical plant was toured inside and out with the Designee. The facility is a one level home and has six (6) bedrooms, four (4) of which are designated for clients use only. One (1) room will be designated for live-in staff and one (1) room will be converted to the office. During inspection, all rooms were properly furnished with bedding, linens and furniture. The facility has and three (3) bathrooms. All bathrooms were observed to be clean and included appropriate functional fixtures. Each client has their own personal hygiene storage unit available. Water temperature measured at 120.0 degrees Fahrenheit. Walls, ceilings, floors, window screens, and all areas of the facility, was clean and in good repair. There is sufficient perishable and nonperishable, and food storage, cabinets, pantries, cupboards and counters were clean and appropriate for food preparation. Knives and medication will be stored in cabinets located in the kitchen area. Appliances were clean and functional, and utensils, plates, and cups were in good repair. Cleaning supplies and chemicals were stored under kitchen sink, locked and secured.

Facility has television available for clients. Facility telephone was operating and available for use. The back yard is completely fenced with a gate easily accessible and unlocked. There are no swimming pools or other bodies of water, no visible hazards around the surrounding grounds. Smoke detectors and carbon monoxide were hard-wired and operational. Fire extinguisher is fully charged. All required Licensing documents were visibly posted on the wall. Facility telephone was operating and available for use.