Facility Evaluation Report

At approximately 9:10AM, Licensing Program Analysts (LPAs) Loera and Felias arrived unannounced to continue a Required 1 Year visit and met with Team Leader, Zasha Deaep. Facility is an Adult Residential Home that provides care and assistance for Adults with Mental Health Diagnoses. Facility has an approved fire clearance and capacity for 10 Ambulatory Clients. Upon arrival, LPAs were informed that there were 7 clients in care and 1 staff member on-site.

LPA's reviewed staff files and client medication. Files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was centrally stored and secure.

Exit interview conducted. Copy of report discussed and provided to Team Leader. Signature on form confirms receipt of documents.