Facility Evaluation Report

On 06/03/2025 at 9:15 a.m., Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced annual inspection using the Inspection Tool. LPA rang the door bell and nobody answered. LPA contacted the Administrator Designee, Willie Jordan by telephone and informed him LPA was at the facility and explained the reason for the visit. LPA met with administrator designee at approximately 9:40 a.m. and was granted access to the facility. Clients were out in the community.

At approximately 9:45 a.m. LPA and the administrator designee toured the physical plant of the facility, and the following was observed.

Upon entry LPA obse rved a small table with a binder, hand sanitizer and mask available for clients, staff and visitors.

Common areas , which include the game room and living room were observed clean and properly furnished. LPA observed a television in each room, games and activities for clients to use. LPA observed a fireplace not in use, closed with a screen.

The kitchen was observed to be clean and clear of clutter. Appliances and fixtures appeared to be functioning properly. LPA observed a sufficient amount of 2-day perishable and 7-day non-perishable supply of food. Administrator stated they do the grocery shopping every Monday or Tuesday and as needed. LPA observed one (1) fire extinguisher fully charged with purchase receipt attached, dated 06/02/2024. LPA observed two (02) dining areas. Dining areas have appropriate table and chairs to sit the capacity of the facility. Clients' centrally stored medications, records and facility files were observed locked in a cabinet by the kitchen. (Continued on to LIC809-C)