Facility Evaluation Report

Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced at approximately 8:15 AM to conduct an Annual Required inspection and was greeted by staff Marie B. who contacted Administrator, Wilson Benoit and Licensee, Wally Hyppolite who arrived shortly after. This tri-level Adult Residential Facility has 6 bedrooms, 2 bathrooms, dining room, living room, kitchen, & recreation room that has a fire clearance approved for 6 Ambulatory clients. Facility has 4 clients, two are currently away at family homes, during inspection there was only 2 at facility and 1 left to day program shortly after LPA arrived, the other was sleeping per Licensee.

LPA and Licensee initiated a tour of the facility at approximately 8:45 AM and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in sinks accessible to clients measured at 120.7 and 122.3 degrees F not within the range of 105 to 120 degrees F allowed per regulation (see LI809-D). Bathroom on 2 nd level was observed to have a bottle of bleach under sink in unlocked cabinet and other empty containers (see pics & LIC809-D).

LPA observed the kitchen to be newly remodeled and in functioning condition. LPA observed cabinet under sink to be locked and contained various cleaning chemicals. Emergency food and water is stored in room outside of kitchen. Upon entering the backyard. LPA and Licensee observed numerous paint cans outside due to various projects that had been done and lock on side yard storage containing painting solvent and additional cans/buckets of paint not having working lock (see pics & LIC809-D).