Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez arrived at the facility unannounced for the purpose of conducting the annual required visit. LPA was greeted and granted entry by House Manager, Dempsey Nicolas and explained the nature of the visit.

The facility is a two story home with an attached garage. Facility is licensed to serve six (6) clients of which two (2) may be non-ambulatory. There are two clients in care during today's visit with three care staff on duty.

LPA toured the interior and exterior portion of the facility and observed the facility to be clean, sanitary, and operational. LPA inspected the kitchen and observed sufficient two day supply of perishables and seven day supply of non-perishable food. There is additional food supply in the spare refrigerator located in the garage. Medication is stored in a kitchen cabinet locked and inaccessible to clients in care. LPA inspected that medication was label and in its original packaging. First aid kit and book observed to be located with medication storage. The first floor consists of four bedrooms occupied by two clients and one staff. Two client bathrooms are also on the first floor. The clients' bedrooms were appropriately furnished and in good condition, adequate lighting was provided, sufficient storage space for personal belongings were observed, and clean linens were adequately stocked. LPA inspected bathrooms and were noted to be in compliance, clean and operational. The water temperature measured at 106.1 degrees Fahrenheit. The second floor consists of three rooms and one bath which is occupied by the staff. LPA observed the evacuation chair stored in a closet by the stairwell. The fireplace was screened. Toxins, disinfectants were locked underneath kitchen sink and in garage storage cabinet. LPA toured the exterior portion of the facility. LPA observed the outdoor