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 ambulatory clients. As of today, the facility has four clients admitted to the facility. All four clients were present at the beginning the visit, and three of them left for their day program after the visit started. There’s a total of 6 bedrooms, of which 4 bedrooms are for the clients, one bedroom has been converted into activity area and one bedroom is vacant and empty. There are two restrooms available. There’s a living room space, a dining space, and activity area and an attached garage/storage area. 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 chemicals observed in the bathroom. Hot water was measured in the range of 105.8 - 107 degrees F. Kitchen: 4 of 4 burners are operational on the gas stove. Sharps are kept locked in a cabinet below the counter next to the chemicals stored in the locked cabinet directly under the sink. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed in the kitchen, and the pantry area above the washer and dryer in the laundry area.

Client & Staff Files : Client and staff files stored in the main office.

File Review: 3 of 4 client files were reviewed during the visit, and 3 staff files were reviewed.