Facility Evaluation Report

At 8:45 a.m. on 04/22/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted a prelicensing visit. LPA met with the applicant and current staff and disclosed the reason for the visit.

Today’s prelicensing visit is conducted due to a change of ownership with clients in care. The previous facility was Fairhaven Home III (197606097). Fairhaven Home III was last visited on 12/29/2022 for an annual visit. The facility is a single story building with seven (07) bedrooms, three (03) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for 6 ambulatory residents.

LPA conducted a record review of client files at 9:00 a.m. All required documents were available for review.

LPA and the applicant toured the facility inside and out at 10:00 a.m.

LPA observed a maintained front yard. Postings were present in the office area for the facility sketch, confidential complaint contacts, facility license, emergency disaster plan, grievance procedure, personal rights, house rules, COVID precautions, and activity schedule. A screening station near the living room contained a digital thermometer, visitor log, hand sanitizer, N95 masks, surgical masks, and gloves.

The facility has seven (07) private bedrooms. Bedroom #7 was locked and served as a staff room. All bedrooms were tidy and contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition.

Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. The living room contained board games and furniture in good condition. A client was observed watching television. At 10:05 a.m. LPA measured the room temperature to be 72 degrees Fahrenheit. A linen closet in the hallway contained an adequate supply of fresh sheets and towels. Another closet nearby contained hygiene supplies.