Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an announced Pre-Licensing visit. LPA met with Shenesia Gladney (Lead Supervisor) and explained the reason for the visit. A change of corporation name application was submitted to Community Care Licensing Department (CCLD) for an Adult Residential Facility to serve 4 ambulatory clients in the age range of 18 through 59.

The facility is in a residential area and it is a one story family home. A tour of the single-story facility included the office area, kitchen, family/dining room, staff office/break room, storage room, 2 client rooms, 2 bathrooms, front yard, backyard, and detached garage.

LPA Mora conducted the tour with Shenesia Gladney and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen and refrigerator in the garage. Sharps were observed locked in a kitchen cabinet. Chemical and cleaning solutions are kept locked in a kitchen cabinet. The First Aid kit is kept locked in the medication cabinet and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway cabinet. Dining and living room have sufficient lighting and sitting area. Medications are kept locked in a cabinet near the family/dining room. Client files are kept in the family/dining room. Staff files are kept locked in the office area. All bedrooms have all required furniture, lighting, and bedding. All bathrooms were observed with shower mats. The water temperature was tested in both bathrooms and measured at 108.2 degrees F and 105.3 degrees F, which is within the required 105-120 degrees F. A fire extinguisher was observed in the kitchen and it is fully charged. Smoke detectors and carbon monoxides were observed throughout the facility and were operable during the visit. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.