Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit.

Structure: The facility is a single level structure and licensed for six ambulatory clients. As of today, the facility has six clients, and four clients were present during the annual inspection. There’s a total of 4 bedrooms for the clients and three client restrooms. There’s a living room space, a dining space and an attached garage. Bedrooms: All bedrooms are clean, organized, and have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water measured in between 107.6 – 108.8 degrees F. Kitchen: Clean and organized. Sharps are locked in a drawer near the sink. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed. An additional supply of perishable food items was observed in the refrigerator in the garage, and there were additional nonperishable items in the pantry.

Client & Staff Files : Client and staff files are located in the office area between the kitchen and garage.

File Review: 4 of 6 client files were reviewed during the visit, and three staff files were reviewed.

Medications/First-Aid Kit: Client medications are stored in a locked medication cabinet located in the office area between the kitchen and garage. The first aid supplies including a first aid manual is located in the office.

Medication Review: 4 of 6 client medications were reviewed during the visit.

Linens & Hygiene Supplies: An additional supply of hygiene items were observed in a locked closet in the office area. An additional supply of hygiene items were observed in the garage.