Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection. LPA arrived unannounced and met with licensee Otis Bennett. The purpose for the visit was explained. The facility is licensed to 6 serve mentally disabled adults, ages 18 to 59, and ambulatory only. There is currently one client residing at the home.

The facility consists of (5) bedrooms, 2 1/2 bathrooms, living room, dining room, den, kitchen, laundry room and a garage. The backyard has an empty pool which is gated. There is a fireplace that is not in use and covered. Knives and cleaning solutions are locked and inaccessible to client. Licensee has submitted the Infection Control Plan and continuing to follow guidance on hand hygiene. Gloves are worn when deemed necessary. Food supplies are sufficient. There is a carbon monoxide detector in the hallway and is operable. Fire drills are conducted monthly. The hot water temperature is measured within the required range of 105 - 120 degrees F.

Licensee/Administrator (Otis Bennett) certificate expires on 3/11/24 and First Aid/CPR training are current. Other individuals residing in the home are fingerprinted cleared. Administrator's file has the required documents, including Health Screening and Tuberculosis results. Client file is maintained at the facility and has the required documents. The administrator does not handle P&I money for client. Medication for client is being administered as prescribed. Administrator provides care and supervision to client at all times. There is no manual restraints used at this home. Client is provided with internet access and device to use.

There are no deficiencies issued today. An exit interview was held and a copy of this report was given to Mr. Bennett.