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.

The facility is a single level structure and licensed for six clients, one of which may be non-ambulatory. As of today, the facility has four clients admitted to the facility. One client was present during the visit. There’s a total of 8 bedrooms of which 4 bedrooms are for the clients and three bedrooms have been converted into activity rooms and one empty room is being used as a storage room. There are two and a half restrooms available. There’s a living room space, a dining space and an attached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. No cleaning chemicals were observed. Kitchen: 4 of 4 burners and the operational on the stove. Sharps are kept locked in a drawer next to the stove. Cleaning chemicals are stored in the kitchen below the sink. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed.

Client & Staff Files : Client and staff files are stored in the main office. Additional files are stored in a locked hallways area with several different cabinets. In the cabinet with the files first aid supplies were observed including a first aid manual.

File Review: 3 of 4 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 in the main hallway area near the dining room.