Facility Evaluation Report

05/08/26 Licensing program analyst (LPA) Villegas conducted an unannounced required annual Inspection, LPA met with Licensee/Administrator Clementine Wallace. LPA explained the purpose of the visit and was accompanied by Licensee inside and outside the facility during this inspection. This facility is licensed to serve 2 ambulatory adults ages 18 – 59 years. The Annual Licensing Fees are current.

The facility is a one-story house located in a residential neighborhood that consists of 1 client bedroom, 2 staff bedrooms, 2 bathrooms, 1 living room, 1 dining room, 1 kitchen, 1 den, 1 detached garage, and 1 backyard patio area with shaded seating. There are no bodies of water around the facility, walkways around the home were clear of hazards.

The client’s bedroom was checked, mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible under lock. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. There are 2 fire extinguishers in the facility.

LPA conducted a records review of 1 staff records, 00 client records, and 00 medication administration records as the facility currently does not have any clients in care.

Exit interview conducted, and a copy of this report was provided.