Facility Evaluation Report

Licensing Program Analysts (LPAs) Dwayne Mason Jr. and Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPAs arrived at the facility and were greeted and granted entry by designated Administrator (AD) Kathrina Buller. An application to operate a Residential Care Facility for Elderly (RCFE) for (15) capacity, (0) ambulatory, (15) non-ambulatory, and (0) bedridden clients was received by CCL on 6/2/2023.

The facility is a two-story home with eight resident bedrooms, three bathrooms, living room, kitchen, dining room two staff bedrooms, staff bathroom and an attached two car garage. LPAs observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the dining room area. There is a back yard with two exit gates on each side of the house. There are five shaded seating areas in the backyard. LPAs did not observe any obstacles or hazards in the backyard.

All resident bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets. LPAs observed all windows were screened.

There is signal system that each of the residents will have access to via handheld device. Each device sends a signal to the signal system’s interface in the med room. This signal will let the staff know which resident needs assistance.

All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored and locked beneath the kitchen sink.