Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced visit for the Annual/Required inspection. Upon arrival at the facility, LPA met with Administrator Cheryl Jackson and

Rosline Bullock who assisted with the visit. During today's visit, LPA used the infection control domain.

The facility is licensed to serve twenty-two (22) Developmentally Disabled Clients ages 18 - 59 years of age. Currently there are 12 regional center clients in care. This is a two story home, consisting of: kitchen, four client bedrooms are located downstairs, seven client bedrooms are located upstairs, three client bathrooms upstairs and two bathrooms located downstairs, garage area, laundry area, medication area, backyard and outside covered area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in the facility.

All the required documents are posted in a clearly visible area, fully charged fire extinguishers, fully stocked first aid kit with current manual and tweezers. During the course of this visit the LPA observed a sufficient number of staff working to meet the needs and provide care & supervision .

All medications are kept locked and inaccessible to the clients. The bathrooms are clean and operational. Client bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The hot water temperature was tested throughout the facility. The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables.

Front and backyards were well maintained and free of debris, all trash bins with lids, laundry room is located in the backyard storage area, all outside covered areas with chair.