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 three clients admitted to the facility. All three clients were present at the beginning the visit, and all three of them left for their day program shortly after the visit started. There’s a total of 4 bedrooms, of which 3 bedrooms are for the clients, one bedroom is currently vacant. There are two restrooms available. There’s a living room space with an office area, 2 dining spaces, 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 chemicals observed in the bathroom. Hot water was measured in the range of 109.4 – 109.9 degrees F. Kitchen: Clean and very well organized. Sharps are kept locked in a cabinet below the counter near the stove. Chemicals are stored in a locked cabinet directly below the sink. Client medications are also stored in a locked cabinet below the countertop. Food Service: A supply of perishable food items was observed in the refrigerator, and a well organized non-perishable food supply was observed in the kitchen cabinet.

Client & Staff Files : Client and staff files are stored in the locked garage area in a filing cabinet.

File Review: 3 of 3 client files were reviewed during the visit, and 2 staff files were reviewed.

Medications/First-Aid Kit: Client medications and the first aid kit are stored in a locked cabinet in the kitchen.

Medication Review: 3 of 3 client medications were reviewed during the visit. No discrepancies were noted.