Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman made an announced visit to conduct a pre-licensing inspection. LPA identified herself and discussed the purpose of the visit. An initial application to operate a Social Rehabilitation Facility was submitted to CCL on 03/22/2024 for a capacity of six ambulatory clients. Upon entry, facility appears clean, safe and sanitary.

LPA along with Management Team toured the facility at 7:42 AM and observed the following:

Structure: Facility is a two story, 5 bedroom, 3 bathroom house with an attached garage and a beige exterior. First floor has 1 bedroom used as a therapy room and one restroom. Second story houses 4 bedrooms and 2 restrooms. Living Room/ Dining Room : Adequate seating is available in the dining room and living room. Bedrooms Clients: Rooms will be single and double occupancy. All rooms are equipped with appropriate lighting, chair, night stand and ample closet space. Bathrooms: All client bathrooms have a working toilet/ wash basin. Facility has sanitizer/ soap and paper towels in the restrooms. Linens & Hygiene Supplies: Facility has bedding, towels and hygiene supplies for clients in care. Emergency Phone Numbers and Exit Plan: Emergency plan/ phone numbers located in facility entrance. Food Service: Facility does not have 2 day perishables but has 7 day non-perishables. There are no clients present. LPA observed ample emergency food and water as well as a facility menu. Smoke Detectors: Smoke detectors/ carbon monoxide detectors are hard wired and were tested operational. Fire extinguishers are mounted and charged. Appliances: Stove, oven, refrigerator, microwave, washer, and dryer are clean and operational. Toxins / Sharps : Facility has secured area for toxins/ sharps in secured closet. Water Temperature: Tested and recorded between 110.1 and 111.2 degrees F in all restrooms. Medications, First-Aid Kit & Book: First aid kit observed contained all required items. Kit contained a first aid manual. Facility to use an electronic medication administration record. Client & Staff File: Records are electronically stored. Reading Material, Games, and Equipment: Facility has an activity schedule including exercise, arts and crafts and outings in the community. CONTINUED ON LIC 809C DATED 08/19/2024.