Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted an Annual Required visit and inspection of the facility. LPA met with Keisha Bailey. Licensee was contacted over the phone. LPA explained the purpose of the visit. During the visit, the CARE tool was used. The facility is licensed to serve five (5) ambulatory residents and one (1) bedridden resident. Hospice waiver granted for 6 clients. At the time of visit 2 residents were in the Day Program and 1 resident was at the Hospital / SNF.

The facility is a single-story home, located in a residential area, that consists of a living room, dining area, (4) resident bedrooms, (2) bathrooms, a kitchen, staff room, attached garage. LPA toured the facility. All indoor and outdoor passageways were free of obstruction. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. The kitchen was inspected. LPA observed all kitchen equipment to be clean and in working condition. LPA observed sufficient supply of perishable and non-perishable foods. Additional food supplies observed in the garage. Appliances such as a microwave, refrigerator and stove were observed to be clean and operating properly. Sharps are locked and inaccessible to residents. A locked storage area in the garage for cleaning solutions and disinfectants was observed. Laundry area observed in the garage. Fire extinguisher was observed in the kitchen, and it is fully charged. Carbon monoxide / Smoke detectors were observed throughout the facility and were tested and operable. The common areas (dining room, living room) are clean and were properly furnished. Resident rooms were sanitary and had the required furniture and furnishings. There is closet space for clothing and other belongings. Extra clean linen was observed in the bedrooms.