Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 2/22/24. LPA met with House Lead, Bree Broach, and explained the purpose of the visit. Administrator, Tonie Piper, arrived shortly thereafter. The facility is licensed to serve 6 ambulatory adults, ages 18 through 59.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tool during the inspection today. The following were observed:

Infection Control: The staff are performing appropriate hand hygiene and wearing gloves when necessary to assist clients. Staff are continuing to clean and disinfect each shift.

Physical Plant & Environment Safety: The facility does not have any pool or bodies of water on the premises. There are 3 client bedrooms, 2 bathrooms, living room, dining room, a den, kitchen, and attached garage. The fireplace is secured with a fence. Each client bedroom has the required furniture. There are no items obstructing the hallways or walkways. Facility has smoke and carbon monoxide combo detectors throughout the facility. Knives and cleaning solutions are locked in the kitchen area. The facility measures and documents the water temperature every shift to ensure the hot water is within the required range of 105-120 degrees F.

Operational Requirements: There are currently 5 clients residing at the home under the assisted living waiver program. Proper care and supervision is being provided to the clients. During the visit, LPA observed a client who utilizes a wheelchair.

Staffing : There is sufficient staffing at the facility. Per the administrator, there are 2 awake staff for the overnight shift monitoring the clients.

Personnel Records-Training : Staff files are maintained at the facility. LPA reviewed 4 Staff files. Administrator (Tonie Piper) has submitted documents to renew the administrator's certificate. LPA verified the documents have been received and is pending approval by the Administrator Certification Bureau. Staff have current CPR/first aid training and sufficient on-going training that meets the annual requirement.