Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA knocked on door and no answer. LPA contacted Director of Quality and Compliance Catherine Mann by telephone who stated Administrator would be arriving shortly. At approximately 1:30 PM, LPA was greeted and granted entry by Administrator Greg Rosenbaum and Director of Quality and Compliance Catherine Mann and explained the reason for the visit.

Facility is licensed for six ambulatory clients and there are four clients currently admitted to the facility. Upon entry, facility appears clean, safe and sanitary.

LPA Lyman along with Director of Quality and Compliance toured the facility at 1:48 PM. LPA toured the physical plant, checked food service, and reviewed facility documentation. The home consists of two stories with two client bedrooms, two common restrooms, medication room, living room, dining room, and kitchen on the first floor and four client bedrooms, client restroom, and two common restrooms on the second floor. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, and shower was free of mold/mildew. Water temperature measured between 105.9 and 113.1 degrees F in facility restrooms. 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 all the required elements including tweezers, scissors and thermometer. LPA observed toxins and sharps are secured. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors and carbon monoxide detectors tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for clients. Exit gates are unlocked and operational. CONT ON LIC 809C DATED 04/16/2026