Facility Evaluation Report

On 01/13/2025 at 9:25 a.m. Licensing Program Analyst (LPA) Evelin Rios arrived at this facility to conduct a unannounced Required Annual Inspection. LPA was greeted by staff #1 (S1) who granted access. S1 called administrator Chary Hallon and informed her LPA was at the facility. LPA Rios signed in and reviewed the appropriate postings on a wall by the entry. The inspection tool was used to complete this visit. Chary met with LPA at 11:00 a.m., LPA Rios explained the reason for the visit. Licensee Asalia Wauls arrived at 12:40 p.m.

At 9:33 a.m., LPA along with S1 began a physical plant tour of the facility inside and out and the following was observed by LPA:

Common Areas: These include the living areas, dining areas and the loft . LPA observed dining, living and loft areas clean and clear of clutter with furniture in good repair. Dining and living room furniture sits the capacity of the facility. LPA observed televisions and board games for clients to use. LPA observed a fireplace that is not in use.

Kitchen: LPA observed a seven day supply of non-perishable food and a two day supply of perishable foods; properly stored. LPA observed pots and pans and sufficient amount of tableware. Facility stores the knives, sharps, first aid kit, emergency supply of food and water, client's medications and facility records in a closet that is maintained locked. LPA observed closet locked. LPA observed two (2) fire extinguishers fully charged with a serviced date of 01/23/2024.

Bedrooms: There are four (4) client bedrooms for single use. LPA observed bedrooms to be properly furnished with a bed, linens, night stand, a chair, drawers, closet, and adequate lighting. While touring bedrooms LPA met with client #1 (C1), who locked their bedroom door. According to S1, staff were able to clean C1's bedroom on 12/26/24 but C1 has documented issues with keeping their bedroom clean. (Continue to LIC809)