Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker made an announced visit and met with Applicant Lilly Jones to conduct a Pre-Licensing evaluation. An application was submitted to the Department of Social Service; Community Care Licensing Division (CCLD) on 01/11/2024, for an initial application for Adult Residential for ages 18-59 years. The requested capacity is for four (4) ambulatory clients Structure: The facility is a two-story single-family home located in a residential neighborhood with four (4) bedrooms, three (3) full bathrooms, a living room, dining area, a den, kitchen, laundry room, office, and family room, The facility has a patio/shaded area and, an indoor/outdoor activity area located in the backyard. A two (2) car detached garage is located in the back left side of the property. Three (3) Exits are located in the living room, kitchen, and den. The front and backyard landscapes were in good condition at the time of the visit. Clients Bedrooms: There shall be no more than two clients per one bedroom. Bedrooms #1, #2, #3, and #4 are designated as the client's bedrooms and have one queen-size bed, chest of drawers, chair, nightstand, lamp, desk, television, closets, and drawer space. Staff Bedroom: There will be no living staff. Bathrooms: The bathrooms have a working toilet, wash basin, and bathtub/shower. Linens & Hygiene Supplies: The required linen/supplies include, a pillowcase, mattress padding, fitted sheet, blanket, and bedspreads. An adequate supply of linens is kept in the hallway linen closet. Hygiene supplies are stored in the kitchen cabinet. Emergency Phone Numbers, Exit Plan, & Menu: Emergency numbers are posted and readily available for review in the front entranceway on the wall bulletin board. The facility has a landline telephone located in the kitchen and den. Three (3) fully charged fire extinguishers are located upstairs and downstairs in the kitchen, living room, and near the office area. 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 locked in the kitchen cabinet drawer.