Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. LPA arrived and was granted entry to the facility by Licensee Cherry Anne Agravante. An initial application to operate a Adult Residential for People with Special Health Care Needs (ARFPSHN) was submitted to the Central Applications Unit (CAU) on 01/09/2024 for a capacity of five adult residents.

Facility is a one-story house with 5 resident bedrooms, 2 bathrooms, family / living room, dining area and kitchen. There is a 3-car garage attached in front of home. The resident bedrooms will accommodate residents' furnishings.

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

Bedrooms #1-5 will accommodate 5 clients (each client will have private bedroom)

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

Adequate supply of linens is stored in hallway cabinet.

Emergency Phone Numbers, Exit Plan, and Sample Menu:

Will be posted and readily available for review in facility.