Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection (change of location). LPA arrived at the facility at 8:40am and was greeted and granted entry by designated Administrator (AD) Janice Jabonero and Licensee Rubylyn Richardson. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden clients was received by Community Care Licensing (CCL) on 10/25/2022.

The facility is a one-story home with four resident bedrooms, two bathrooms, living room, kitchen, dining room, laundry room, an attached two car garage and backyard. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the dining room. There is a back yard with one exit gate. The facility has a shaded patio set that is currently in use at the existing facility. This will be brought over to the new facility when the residents move in. LPA did not observe any obstacles or hazards in the backyard.

All resident bedrooms had beds. Resident furniture is currently in use at the existing facility. These will be brought over to the new facility when the residents move in. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. Bedrooms 2 and 3 have sliding doors leading to the backyard. Bedroom 3 has a door alarm installed and functional. AD showed LPA the alarm that will be installed in Bedroom 2.

Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored and locked in the cabinet in the laundry room