Facility Evaluation Report

Licensing Program Analysts (LPAs) Claudia Gutierrez and Dwayne Mason made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPAs met with designated Administrator (AD) Tyler Michaelis and Compliance Officers Wendy Galvan, Laura Hagan, Christina Farschian. An application to operate a Social Rehabilitation Facility (SRF) for (6) capacity, (6) ambulatory, (0) non-ambulatory, and (0) bedridden clients was received by CCL on 11/15/2022.

The facility is a two-story house with three client bedrooms, a medication room, three bathrooms, two living room areas, a kitchen, a dining room area, a laundry room, and attached two car garage. LPAs observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entryway of the facility. There is a backyard with an exit gate on each side of the house, however only westside exit is designated as an emergency exit. There is a shaded seating area and LPAs did not observe any obstacles or hazards in the backyard.

All client bedrooms had the required furnishings. LPAs observed all beds had linens and blankets.

All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients and will be stored and locked in the garage.

Medication will be stored in locked medication room. First aid kit is stored with the medication. The first aid kit has all the required elements.

Records will be kept locked in medication room.