Facility Evaluation Report

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced required annual inspection. LPA Rodriguez explained reason for visit and was greeted and granted entry by staff on duty. During the visit, three staff members were on duty of which all were background cleared and associated on Guardian. Staff on duty contacted Chief Clinical/Operations Officer- Nilou Farnekou and Compliance Manager - Whitney Buss about visit. The PUB475 "See Something, Say Something" poster was observed at the entrance of the facility.

LPA De Perio toured the interior and exterior portions of the facility with staff on duty (S1). The facility is a two level structure and is licensed for 6 clients. For this visit, there are a total of 6 clients in care. There are a total of 2 private client bedrooms and 2 client shared bedrooms. All bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards.

Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. The restrooms were observed to be in good repair, toilets were operational. Water temperature in restrooms were measured at 111.2 degrees Fahrenheit.

Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to clients in care. LPA Rodriguez observed fire extinguishers charged, mounted and located in multiple areas of the facility. LPA Rodriguez observed the emergency disaster and evacuation plan, which is posted in the staff office. Facility had back-up emergency food and water supply, located in the garage. LPA Rodriguez observed that the facility First Aid Kit had all the required components. Medications and toxins were also observed to be locked and inaccessible to clients in care.