Facility Evaluation Report

On 01/21/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced 1-year Required Annual Visit. LPA met with House Manager, Mary Magaben, and the purpose of today’s visit was explained. LPA was granted entry into the facility.

The facility is licensed to serve four (4) ambulatory clients, two (2) of which may be non-ambulatory, and two (2) of which may be bedridden. The facility has an approved hospice waiver for four (4) clients. There are currently four (4) Clients residing in the facility.

Physical Plant/Structure The facility is a single-story structure in a residential neighborhood. It consists of four (4) Client bedrooms, three (3) bathrooms, an office, living room, dining room, kitchen, pantry, attached garage, and shaded patio area. All walkways outside the facility were observed clean, clear, and free of debris, hazards and obstructions. The shaded patio has a table and chairs available for client use.

Bedrooms LPA inspected all client rooms and observed them to be clean and in good repair. All rooms were observed with the required furniture including a bed, dresser, nightstand with lamp, chair and ample storage space for residents’ personal belongings. LPA observed beds have the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed an ample supply of bed linens in good repair.

Bathrooms LPA inspected client’s bathrooms and observed them to be within Title 22 Regulations. LPA observed the toilet, faucets and showers working properly. LPA observed secured safety handrails, shower chairs, and non-skid material in the shower. LPA observed the showers to be clean and free of mildew and/or mold. The water temperature measured 106.2- degrees, 107.9- degrees, and 109.5- degrees Fahrenheit. LPA observed an ample supply of bath towels, toiletries, and personal hygiene supplies were adequately stocked.