Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. LPA Hurt arrived and was granted entry to the facility by Administrator Maria Simon . An initial application to operate a Adult Residential Facility (ARF) was submitted to the Central Applications Unit (CAU) on 11/10/2022 for a capacity of four adult residents.

Facility is a one-story house with 4 resident bedrooms, 2 bathrooms, 1 staff room, 1 storage room, 1 office, family / living room, dining area and kitchen. The resident bedrooms will accommodate residents' furnishings.

Central air/heating system installed with a central panel to control entire house.

Bedrooms #1-4 will accommodate 4 clients (each have their own bedroom)

All bathrooms have a working toilet, wash basin, and shower.

Adequate supply of linens is stored on shelf inside staff room area.

Emergency Phone Numbers, Exit Plan, and Sample Menu:

Are currently posted and readily available for review in the living room.