Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by lead DSP staff Leah Sarian. The facility is licensed for 6 ambulatory clients. Currently there are 3 clients living here during today's visit.

LPA Tea reviewed three client files and one staff file. Client and staff files contained all required documentation. The administrator certificate expires on April 23, 2026

LPA Tea along with staff toured the facility at 9:41 AM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one-story home with four client bedrooms, one staff room, and two and half bathrooms. The facility has a kitchen, dining room, and living room, and garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and shower was free of mold/mildew. Water temperature measured around 117.8 Fahrenheit degrees. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had most of the required elements including dressing, bandages, tweezers, and scissors. The only thing missing was a thermometer. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Sharps are stored in staff room, making them inaccessible to clients in care. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the sink, laundry area, and garage. Fire extinguishers are fully charged throughout the facility. The facility’s last fire drill was