Facility Evaluation Report

On 6/15/26, 10:00 am, Licensing Program Analyst (LPA) Raymond Comer conducted an unannounced annual visit to this facility. LPA met with the Administrator, and reason for the visit was discussed.

Facility is licensed as a single-story residence; fire clearance licensed for five (5) non-ambulatory; level four clients. Facility has a total of four (4) bedrooms, and two (2) bathrooms.

LPA conducted a tour of the physical plant with the Administrator and observed the following:

Physical plant: was inspected for cleanliness and condition . Facility’s main door is the primary entry/exit access. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Hand washing, coughing etiquette, and other necessary signage are posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 75.0°F . within the required range. Required postings are prominently displayed and observed to be current. Passageways and entrance were clear of obstruction. Disaster drills were last conducted on 5/26/26.

Fire detection: Is present in the facility. Smoke detectors and Carbon Monoxide detectors were tested and were working properly at the time of visit. LPA observed two (2) fire extinguishers; one (1) located in the kitchen, and the other located in the hallway; both were fully charged with a serviced date of 04/07/2026 .