Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Maxine Kniazeff and discussed the purpose of the visit. The facility currently has four clients in care.

The facility is a one story home with four client bedrooms, two client bathrooms, an activity room, storage room, living room, dining room, kitchen, staff office, staff bathroom and attached garage. The facility appears clean, safe and sanitary. LPA observed one client present at the facility during the inspection. All client bedrooms had the required components and furnishings. LPA observed a clean supply of extra linens in the hall by the front two client bedrooms. LPA observed the bathrooms to be supplied with soap, paper towels and toilet paper. LPA tested the water to be between 113.3-115.3 degrees Fahrenheit. LPA observed the kitchen to be free of vermin. LPA observed a fire extinguisher charged and with a service date of September 30, 2025. LPA observed a two day perishable and seven day nonperishable food supply on hand. LPA observed the sharps to be in a locked kitchen drawer and made inaccessible to clients in care. LPA observed the toxins to be under the locked kitchen sink and made inaccessible to clients in care. LPA observed the emergency food and water supply to be in a closet located in the dining room. LPA observed the centrally stored medication to be in a locked cabinet in the front room by the living room and made inaccessible to clients in care. LPA observed the activity room was converted from a bedroom. LPA observed the storage room to have mattresses standing up and appeared to be stored in a way that they are not in use. AD informed LPA that they just purchased new mattresses for the clients in care and have not disposed of the old ones yet. The storage room was converted from a bedroom. LPA observed the staff office to lock and be made inaccessible to clients in care. LPA observed the garage to be used as a staff break room and storage. LPA observed a shaded seating area in the backyard for client use. LPA observed no debris and obstructions in the backyard. LPA and AD tested the fire alarms and they were found to be operational. LPA did not observe a carbon monoxide detector located in the facility. Continue on LIC809C