Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility using the CARE Tool. LPA Mora met with Shirrel Smith (Licensee) and explained the reason for the visit. The facility is licensed to serve three (3) ambulatory and one (1) non-ambulatory developmentally disabled adults ages 18 through 59. The facility is operating within the scope of the license.

A tour of the single-story facility included the living room, family room, kitchen, 4 bedrooms, 2 bathrooms, laundry area, front yard, backyard and a detached garage/storage. LPA Mora conducted the tour with Shirrel Smith 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. Sharps, chemicals and cleaning solutions are kept locked in a cabinet in the backyard patio. 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 closet. Dining and living room have sufficient lighting and sitting area. Medications are kept locked in a cabinet located in the family room. Client and staff files are kept in a family room cabinet. All bedrooms have all required furniture, lighting, and bedding. All bathrooms were observed with shower mats and grab bars for non-ambulatory clients. The water temperature was tested in both bathrooms and measured at 105.2 degrees F and 105.7 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 were observed throughout the facility and in each room and were operable during the visit. A carbon monoxide was observed in the family room and was not working properly. During the visit, the Licensee purchased a new carbon monoxide and installed it in the living room. 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.

LPA reviewed medication for 2 clients and observed that medications are documented properly and given as prescribed. Client 1 (C1) has no medication prescribed and Client 3 (C3) has been in the hospitalized since 02/23/2023. (Continued to LIC 809-C)