Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an announced pre-licensing visit on 4/18/2024 and was met by Administrator Tonie Piper. The facility will be licensed as an Adult Residential facility to serve 4 ambulatory and 2 non-ambulatory consumers within the age of 18-59 years.

Structure: Facility is a single-story home located in a residential area consisting of three (3) bedrooms, two (2) bathrooms, kitchen, dining room, living room, laundry area in attached garage, and backyard with outdoor covered patio. Front yard is landscaped with grass and back yard is landscaped. Bedroom Clients: Bedrooms are all shared. Bedroom#1 and 2 are designated ambulatory. Bedroom#3 is designated for non-amulatory.Bedrooms are equipped with one bed, nightstand, chair, lamp, and overhead lighting. Bathrooms: Two (2) full bathrooms equipped with working toilets, wash basins, bathtub/ walk-in shower. Bathroom#2 is located in shared bedroom#3. Linens & Hygiene Supplies: All beds had the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linens is stored in linen closets. Emergency Phone Numbers, Exit Plan: Emergency numbers are posted and readily available for review. Two (2) fully charged fire extinguisher was observed. Facility has a land line telephone. Food Service: Dishes, cups, and flatware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery, and other sharp kitchen utensils were observed locked and inaccessible. Adequate food supply is stored in the kitchen and consists of the following: 2-day perishables, and 7-day non-perishables. Emergency water supply was observed. Smoke Detectors: There are electrical & inter-connected smoke detectors located in all bedrooms, common areas, and hallways. Appliances: Refrigerator , oven, microwave, dishwasher and washer/dryer are in good condition. The residence is equipped with central heating and air conditioning. Toxins: Cleaning supplies, and toxins are locked only accessible to staff.