Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez made an announced visit for the purpose of conducting a Pre-Licensing inspection. LPA met with Applicant (AP) Kevin Clark. An initial application to operate an Adult Residential Facility (ARF) for four (4) Ambulatory clients was received on 03/16/2023.

The facility is a two story home with an attached two car garage that will be used for storage. There are 4 bedrooms on the second floor, 3 bathrooms, a dining room, a living room, and a kitchen. Bedrooms are spacious and will easily accommodate client's furnishings. There is a large back yard with 1 exit walkway on each side of the house. There is a covered patio with table and chairs for clients and visitor's use.

Central air/heating system installed with a central panel to control entire house.

Bedrooms will be private and accommodate 4 clients.

Facility will have hourly staff; no live-in.

Bathrooms have a working toilet, wash basin, and showers.

Adequate supply of linen stored in hallway closet upstairs. Hygiene supplies to be stored in locked medication closet.

Emergency Phone Numbers, Exit Plan & Menu:

Posted & available for review is Emergency Disaster Plan with means of exiting; Emergency phone numbers listed. Menus will be posted and available. Menus to be prepared one week prior and listed for food served for one week. Continued on LIC809-C