Facility Evaluation Report

On 7/22/24 Licensing Program Analyst (LPA), Felisa Shirley conducted an announced visit to the above facility for purpose of a pre-licensing evaluation. During the inspection LPA toured the inside and outside of the facility.

An application was submitted to CCLD on 4/17/24, for an initial application for an Adult Residential Facility to serve Developmentally Disabled Adults for ages 18 to 59 years. The requested capacity is for 4 clients, all ambulatory. Facility has a fire clearance for 4 ambulatory.

Structure: Facility is a 4 client-bedroom, 1 office, 2-bathroom, one-story house. The client bedrooms are spacious and easily accommodate the client's furnishings. There is a back yard with a shaded patio area and chairs. Shaded area has sufficient tables and chairs for clients. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility.

Bedrooms Residents: Facility has 4 ambulatory bedrooms. Bedrooms 1 thru 4 has one bed, one chair, night stand, dresser, ample lighting, and closet. Bedroom 5 will be used as an office.

Office: Facility has an office that has a bed currently but will be converted to an office which will store a locked file cabinet for both staff and resident files.

Bathrooms: Facility has two bathrooms. Both bathrooms were observed to have working toilets, wash basins and showers. LPA observed adequate lighting in hallway leading to bathrooms.

Linens & Hygiene Supplies: Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen; sheets, and pillow cases.