Facility Evaluation Report

On 10/13/22 Licensing Program Analyst (LPA) Joscelyn Martinez arrived at the facility to conduct an announced Pre-licensing Inspection. Upon arrival LPA met with Administrator Kimberly Tady. This is an application for Adult Residential Facility and has been approved for a total capacity of six (6) clients. Fire clearance has approved bedrooms three (3) and four (4) for non-ambulatory clients. The facility is a single-story home with four (4) bedrooms and two (2) bathrooms.

Common Area: LPA observed the living room and furniture to be clean and in good repair. Living area has a fireplace with appropriate covering. The facility maintains a comfortable temperature of 69 degrees F and has a functional air conditioner. No firearms observed or will be maintained on the premises. The smoke alarm and carbon monoxide detector were operational and tested at 10:42 a.m. The fire extinguisher was observed to be with a full charge and with a purchase date of 05/10/22. Facility will always maintain a cellphone and a land line in the facility for clients use

Kitchen/Dinning Area: LPA observed the kitchen area to be in good repair and sanitary. LPA observed a startup fully of food as well as emergency food. Sharps and medications were observed to be locked and inaccessible to residents. Trash can contain a tight-fitting lid. Appropriate plates and cups were observed. No chemicals will be stored in the kitchen area. LPA observed the dining area to be clean and in good repair. Activities were observed in the dining room area. First aid kit was observed with all the appropriate requirements.

Bedrooms: Facility has four (4) bedrooms of which all will be used for clients. Bedroom three (3) and four (4) are shared and bedroom one (1) and two (2) will be for single use. All bedrooms were toured and observed with appropriate furniture and bedding. Thrash cans in bedrooms all contained tight fitting lids to prevent cross contamination.