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 four clients, one of which may be non-ambulatory. As of today, the facility has four clients admitted to the facility. Three clients were present at the beginning of the visit and one client was already at school. There’s a total of 6 bedrooms of which 4 bedrooms are for the clients and two bedrooms have been converted into an office/therapy area and one activity/quiet room. There are two 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. Hot water measured in between 110 – 116 degrees F. Kitchen: 4 of 4 burners and the warmer were operational on the gas stove. Sharps are kept locked below the sink. 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 in the kitchen area and pantry.

Client & Staff Files : Client and staff files are located in room #5 which has been converted into an office space and therapy area for the clients. There’s a stationary bike and a treadmill for the clients to enjoy.

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 double locked medication cabinet in the kitchen. A first aid kit with all the required elements is located in the locked medication cabinet.