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 for day program shortly after the inspection started. The facility has a total of 6 bedrooms, and all of them are for the clients. There are three restrooms available, two for clients and one for staff. There’s a living room space, a dining space and a detached 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 113.9 – 118.5 degrees F. Kitchen: 4 of 4 burners and the warmer were operational on the gas stove. Sharps are kept in a toolbox in the locked cabinet directly below the sink. Cleaning chemicals are also stored in the locked cabinet 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 closet near the office area.

Client & Staff Files : Client and staff files are located in the staff office area.

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 the staff office in a locked filing cabinet. There’s a first aid bag pack style kit with all the required elements in the office.