Facility Evaluation Report

At 1:40 p.m. on 04/12/2024, Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced annual inspection. LPA met with Administrator and explain the reason for the visit. Administrator and LPA toured the facility inside and out.

The facility was last inspected on 04/06/2022 for an annual inspection. It is a two story building with 5 bedrooms, 2 bathrooms, kitchen, nook, living room, recreation room, dining room, storage closets, garage, front and back yard. The fifth bedroom is upstairs and is not included on the facility sketch. The facility has an approved fire clearance for 6 ambulatory clients.

Record Reviewed: LPA reviewed files for clients and staff regularly scheduled at the facility. Client files were reviewed for admission agreements, medical assessments, appraisals, consent forms and medication records. During a review of records with the Administrator, it was observed that the last disaster drill was conducted on 11/15/2023.

Bedrooms: The facility has 5 bedrooms in total. The bedroom on the second floor is a staff bedroom. The bedroom on the northeast corner of the facility is designated as a staff office. The staff bedroom and staff office were locked. All other rooms are client shared bedrooms. All lights where working and furniture was clean and in good repair.

Bathrooms: LPA inspected the bathroom designated for clients it has toilet paper, and a hand blower. All fixtures are clean and in great working condition. At 2:00p.m. LPA measured the water temperature to be 116.2 degrees Fahrenheit.