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 six clients admitted to the facility. All six clients were present at the beginning of the visit, and four of them left shortly after the visit started. There’s a total of 6 bedrooms and two bathrooms. There’s a living room space, a dining space, laundry area, backyard 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 107.7 – 117.1 degrees F. Kitchen: 4 of 4 burners are operational on the gas stove. Sharps are kept locked in a cabinet. Cleaning chemicals are stored in a locked cabinet directly 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 the main office.

File Review: 3 of 6 client files were reviewed during the visit, and 3 staff files were reviewed.

Medications/First-Aid Kit: Client medications are stored in a locked medication cabinet in the kitchen. A first aid kit with all the required elements is located in the locked medication cabinet.

Garage Area: The garage is clean and well organized. There are additional cabinets in the garage used to store additional cleaning supplies and an additional supply of hygiene items. There are also incontinent care supplies in the garage. There’s a laundry area with a washer and dryer next to the dining room.