Facility Evaluation Report

Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced annual inspection using the CARE Inspection Tool. LPA rang the door bell and was greeted by a staff member. The staff member granted accesses and contacted the administrator and administrator designee, Elizabeth Grigoryan. LPA informed the staff member the reason for the visit. LPA met with the administrator and administrator designee shortly after.

At approximately 8:20 a.m. LPA and S1 toured the physical plant of the facility inside and out, and the following was observed. At entry, LPA observed a required poster prominently displayed and easily visible to clients and visitors. The four clients were out in the community.

Bedrooms: LPA inspected four (4) out of four (4) client bedrooms. Bedrooms are for private use. LPA observed each client room to be properly furnished with one bed, appropriate night stand, chair, bedding and with sufficient lighting and storage.

Bathrooms: The facility has two (2) bathrooms available for clients and visitors to use. LPA took hot water temperature from one (1) out two (2) client bathrooms and temperature measured at 110.7 degrees Fahrenheit, within regulation. LPA observed both bathrooms to be clean and properly supplied with toilet paper, hand soap, and paper towels.

Laundry Service: Laundry room is located by the bedrooms. Detergents, extra cleaning supplies, and toiletries where observed locked in a closet by the laundry room. Clients are able to do their own laundry with staff supervision. (Continued on to LIC809-C)