Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Maryann Davis and explained the reason for the visit.

Facility is licensed as a Social Rehabilitation Facility to serve 6 ambulatory clients. The facility is a two story home located in a residential area and consist of 3 client bedrooms, 3 bathrooms, a staff bathroom, a kitchen, a living room, an activity room, a laundry room in the basement, a front porch, a detached garage, and a back yard.

The following CARE tool domains were reviewed during this visit:

Infection Control: Facility maintains an infection control plan. Hand sanitizing and infection prevention were observed at the facility. A responsible person was available at the facility.

Physical Plant & Environmental Safety: LPA toured the facility with Maryann Davis and Cory Mitchell and observed the facility is mostly in good repair indoor and outdoor. Kitchen was observed clean. Cleaning supplies and sharps were observed locked in storage cabinets. Living room and activity room were observed with sufficient furniture each have a fireplace that are not currently working. Stairways are cleared. LPA observed (3) shared client bedrooms with sufficient lighting, furniture, and bedding supplies. Three (3) bathrooms were observed in good repair and water temperature was tested between 106.5 - 108.1 degrees F., which is within the required 105-120 degrees F. Ceiling in bathroom #1 was observed with wallpaper peeling. Smoke detectors were tested and in working condition. Laundry area is located in the basement. Front porch and backyard offer shaded seating area for the client. Garage is not accessible to the clients. Passageways and exit areas were observed free of obstructions. No large bodies of water were observed. Back porch fence was observed with paint peeling. (CONTINUED ON LIC 809C)