Facility Evaluation Report

On 12/01/2023 at 1:50 p.m. Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced required annual inspection. LPA was greeted by administrator Willie Jordan. LPA explained the reason for the visit. Entrance Interview conducted.

The facility has three (3) client bedrooms that are shared and (3) bathrooms. The facility is Fire Cleared for six (6) ambulatory clients.

A tour of the physical plant was conducted with the administrator at approximately 2:00 p.m. and the following was observed:

Kitchen: LPA conducted a tour of the kitchen and observed there to be sufficient supply of two-day perishables and seven-day non-perishables foods, properly stored. Food storage and preparation areas are clean and clear of clutter. LPAs observed all sharp objects, locked in a kitchen cabinet inaccessible to clients in care. LPA observed a fire extinguisher located in the kitchen fully charged.

Living and dining areas: LPA observed the living area and dining area to be clean and clear of clutter. The furniture was in good repair and sits the capacity of the facility. At 2:10 p.m. LPA observed Administrator test a smoke detector. Detectors are dual Carbon Monoxide and are interconnected to other detectors located through out the facility. LPA observed smoke/carbon monoxide detectors functioning properly.

Bedrooms: LPA inspected three (3) out of three (3) client bedrooms. Bedrooms are shared. LPA observed each client room to be properly furnished with two beds, bedding and with sufficient lighting and storage. LPA also observed a fourth bedroom used by clients as a game room. (Continued on LIC809-C)