Facility Evaluation Report

Licensing Program Analyst (LPA) Hansen conducted an unannounced Annual inspection to this facility and was welcome by staff Cheryl. Administrator Michael Sus was contacted by staff and arrived during the visit. Adult Residential Facility is tri-level with 3 bedrooms, one on each floor with a fire clearance approved 6/25/1997 for 6 ambulatory clients. There are 6 clients in the facility. Five clients had left to attend their day programs at the time of the visit and the last client was waiting for pickup.

LPA toured the facility on 7/31/2025 at 8:40 AM with staff, facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Client’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 12/11/2024 at the time of the visit. Facility smoke detectors and carbon monoxide are combined and throughout facility and were found to be functioning properly at the time of the visit. Hot water temperature measured between 116.2 degrees F and 117.8 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 3 of 3 client’s bathroom while touring facility on 7/31/2025. The bathroom designated for clients at the facility were supplied with individual paper towels; hand soap dispenser was available. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked cabinet inside the facility kitchen. Dangerous items were stored inaccessible to clients. There was a supply of cleaners, hygiene products and paper products available for clients. All client’s bedrooms have lighting & appropriate furnishings, and beds were outfitted with mattress pads although clients are not required to have mattress pads.