Facility Evaluation Report

On 07/09/25 Licensing Program Analyst (LPA) Villegas conducted an unannounced visit to conduct the required annual inspection, using the new Care Tool. LPA met with Administrator Detra Perkins, as the purpose of today’s visit was explained. The facility is licensed to serve 6 developmentally disabled clients (age 18-59) ambulatory only. The facility has no clients nor staff. Administrator certificate 6064595735 is current, facility fees are current.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 2 bathrooms, dining room, kitchen, living room, outdoor shaded area, and a detached garage that is used as an Administrator office. LPA conducted a records review of (0) client records, (0) staff records, (0) clients Personal & Incidental Records and reviewed the facility disaster plan. The facility disaster plan is current. All client rooms were checked. Beds and bedding are in good condition, adequate lighting provided, adequate storage for client personal belongings was observed. Toilets and water faucets worked properly. The shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible for future clients. The water temperature in the kitchen measured 105-120F.. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were observed to be locked. The kitchen was inspected, all appliances are operable. First aid kit was checked and fully stocked . The fire extinguisher was charged, smoke/ carbon monoxide detectors are operable. There are no bodies of water or firearm/ammunition on the premises.

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