Facility Evaluation Report

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced Annual Required visit and inspection of the facility. LPA met with staff, Jannie Blake and explained the reason for the visit.

The facility is a two story building with 5 bedrooms and 2 bathrooms. The fifth bedroom is upstairs and includes a full bathroom; the second floor is not included on the facility sketch. The administrator will submit an updated sketch to include all rooms on both floors. The facility has an approved fire clearance for 6 ambulatory clients; current census is five (5).

LPA spoke with Administrator - Samuel Blake, who stated that is unable to visit the facility today but he designated Jannie Blake-Care giver to sign the report. At 10:45am, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the kitchen. The smoke alarms are hardwired and interconnected. The carbon monoxide/smoke detectors were tested to be functioning properly. The fire extinguisher is located in the kitchen and has a charge date of 09/12/2025.

Kitchen : LPA observed a refrigerator, stove, microwave oven, dishwasher and laundry machines in the kitchen. Sharp objects were locked in a cabinet in the kitchen and cleaning solutions and detergents were locked under the sink. There is a large supply of dishes in the cabinets. Facility has perishable foods for two (2) days in the refrigerator. LPA observed two additional freezers and a refrigerator in the garage, with perishable foods for two (2) days in the garage refrigerator, freezers and cabinets. A supply of non- perishable foods for seven (7) days were kept in the garage as well. Facility keeps a supply of detergents and chemicals in the garage cabinet, separate from the food supplies.