Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an announced pre-licensing visit. LPA met with Henry Palma (Applicant) and Imeh Etudoh (Applicant).

This is a single-story home that consists of: (4) bedrooms, (2) bathrooms [1 is located inside bedroom #2], kitchen, dining area, living room and attached garage. The facility is to serve (4) ambulatory clients age 18 through 59 years old. Each client will have their own bedroom. Component III was also completed during this visit.

Smoke detectors were tested and operable.

Carbon monoxide detector was tested and operable (located in the hallway).

Fire extinguisher (full) located in the kitchen appeared to be full.

Cleaning solutions (under kitchen sink) and sharps are locked in the kitchen.

Building and grounds are free from hazards.

Bedrooms are large enough to allow for easy passage between and comfortable for usage of beds and other required items of furniture.

Clients have the appropriate furniture (one chair, night-stand, adequate closet and drawer space).

***Refer to LIC 809C for the continuation of this report**