Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Panushkina conducted a Pre-Licensing Inspection and met with the Administrator, Diane Flin. This is a Change of Ownership Application from facility # 197610461 to # 197610497 . An Application to operate a Social Rehabilitation Facility, Short-Term Crisis Residential Treatment Program was received by Community Care Licensing (CCL). A fire clearance was approved on 03/22/24 for a maximum capacity of six (6) ambulatory adults.

A tour of the physical plant was initiated at 10:40am. The facility site consists of a two (2) story single family home. A tour of the physical plant was conducted and the following observed:

KITCHEN: There were sufficient supplies of both cook ware and dining ware as well as nonperishable food (2 days) and perishable food (7 days) to accommodate a maximum capacity of six (6) clients. The appliances and fixture appeared clean, sanitary and functional.

BEDROOMS: There are six (6) private bedrooms designated for client use. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space, and four bedrooms have a private bathroom available for clients use. Two (2) private bedrooms, downstair by the kitchen area, have a shared bathroom. The bedrooms were appropriately furnished and had sufficient supplies of bedding and linens.

BATHROOMS: All bathrooms had functional fixtures and were properly supplied. A hot water was tested and measured at 120.00F.

COMMON AREAS: These consist of dining room, living room and a family room. All common rooms were