Facility Evaluation Report

License Program Analysts (LPA) Luis De Leon conducted an unannounced annual required visit. LPA met with Residential Manager Amanda Walker. The purpose of today’s visit was explained. The facility is licensed to serve 18 adults ages 18-59 of which 16 are ambulatory and 2 non-ambulatory clients.

The LPA use the Compliance & Regulatory Enforcement Tool (CARE) during today’s inspection. The visit consisted as follows:

The facility is a two-story building with parking garage in the basement. LPA toured the facility's physical plant indoor and outdoor, laundry room, four bathrooms, office, and 9 client bedrooms. All indoor and outdoor passages were free of obstruction. LPA observed two full bathrooms on each floor for clients use. All bathrooms were observed to be clean and had the required hygiene items. There are no large bodies of water on the premises such as pools.

Client record review consisted of Admission Agreements, Identification and Emergency Info, Physicians Report, Consent Report, Needs and Service Plan, Personal Rights, and Centrally Store Medication. LPA was unable to review Physician’s report for Clients #2-#5 (C2-C5) and Needs and service plan for clients #2-#5 (C2-C5). A deficiency is noted on LIC-809D for clients records not available to review. Staff records were not available for LPA to review. Staff records are not stored at facility. A deficiency will be noted for records not available for licensing agency to inspect, audit, and copy upon demand during normal business hours. (Report continues on page LIC-809C...)